右美托咪定对老年骨质疏松合并股骨颈骨折患者术后苏醒质量、 定量脑电图和谵妄的影响.

Effect of Dexmedetomidine on Postoperative Recovery Quality, Quantitative Electroencephalogram and Delirium in Elderly Patients with Osteoporosis Complicated with Femoral Neck Fracture.

Objective:To investigate the effect of dexmedetomidine (Dex) on postoperative recovery quality, quantitative electroencephalogram and delirium in elderly patients with osteoporosis complicated with femoral neck fracture. Methods: 97 elderly patients with osteoporosis complicated with femoral neck fracture who were treated in our hospital from January 2016 to March 2021 were selected, they were randomly divided into control group (48 cases) and Dex group (49 cases) by the random number table method. Total hip arthroplasty was performed in both groups, and Dex group was given 0.5 μg/kg Dex before anesthesia induction, and the control group was given the same amount of normal saline. The wake-up quality, hemodynamic changes and quantitative electroencephalogram frequency of the two groups were observed, and the occurrence of delirium and adverse anesthetic reactions were recorded. Results: Compared with the control group, the respiratory recovery time, extubation time and eye-opening time in Dex group were earlier (P<0.05). The heart rate (HR) at surgical excision of skin (T2)~finish the operation (T4) time point in both groups was lower than that at before anesthesia (T1) time point, and the mean arterial pressure (MAP) was higher than that at T1 time point, the intra-group comparison difference was statistically significant (P<0.05). HR at T2~T4 time point in Dex group was higher than that in control group, MAP was lower than that in control group at corresponding time points (P<0.05). δ wave frequencies of left frontal region, right frontal region, left temporal region and right temporal region in both groups at 1d after operation were increased compared with those before operation, and the Dex group was lower than the control group (P<0.05). The α1 wave frequencies of left frontal region, right frontal region, left temporal region and right temporal region in both groups at 1d after operation decreased compared with those before operation, and Dex group was higher than control group (P<0.05). The incidence of postoperative delirium in Dex group was lower than that in control group (P<0.05). There was no statistical difference in the incidence of adverse anesthetic reactions between the two groups (P>0.05). Conclusion: Dex is given to elderly patients with osteoporosis complicated with femoral neck fracture during operation, can improve the quality of postoper ative recovery without aggravating blood flow fluctuation, alleviate the influence on the δ, α1 wave frequency of the frontal lobe of the patient, and it can reduce the incidence of delirium. [ABSTRACT FROM AUTHOR]

目的：探讨右美托咪定（Dex）对老年骨质疏松合并股骨颈骨折患者术后苏醒质量、定量脑电图和谵妄的影响。方法：选择 2016 年 1 月 -2021 年 3 月期间我院收治的老年骨质疏松合并股骨颈骨折患者 97 例，将其根据随机数字表法分为对照组（48 例） 和 Dex 组（49 例），两组均行全髋关节置换术治疗，Dex 组麻醉诱导前给予 0.5 μg/kg Dex，对照组予以等量生理盐水，观察两组术 后苏醒质量、血流动力学变化、定量脑电图频率，记录两组谵妄和麻醉不良反应发生情况。结果：与对照组相比，Dex 组呼吸恢复时 间、拔管时间、睁眼时间更短（P<0.05）。两组手术切皮时（T2）~ 术毕时（T4）时间点心率（HR）均低于麻醉前（T1）时间点，平均动脉 压（MAP）均高于 T1 时间点，组内对比差异有统计学意义（P<0.05）。Dex 组 T2~T4 时间点 HR 高于对照组对应时间点，MAP 低于 对照组对应时间点（P<0.05）。Dex 组术后 1 d 左 / 右颞区、左 / 右额区 δ 波频率低于对照组（P<0.05）。Dex 组术后 1 d 左 / 右颞区、 左 / 右额区 α1 波频率高于对照组（P<0.05）。Dex 组术后谵妄发生率低于对照组（P<0.05）。两组间麻醉不良反应发生率无统计学 差异（P>0.05）。结论：老年骨质疏松合并股骨颈骨折患者手术期间予以 Dex，可改善患者术后苏醒质量，且对血流动力学影响较 小，可减轻对患者大脑额叶 δ、α1 波频率的影响，同时降低谵妄的发生率。 [ABSTRACT FROM AUTHOR]

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