右美托咪定对食管癌全麻术中单肺通气患者手术后认知功能障碍的影响

【目的】探讨食管癌全身麻醉术中单肺通气（OLV）患者应用右美托咪定（Dex）对手术后认知功能障碍（POCD）的影响。【方法】本院诊治的食管癌根治术患者74例，将患者随机分为观察组（ n ＝40）和对照组（ n ＝34），观察组麻醉诱导后静脉注射Dex ，对照组麻醉诱导后注射等量生理盐水。比较两组手术情况，简易智力状态检查表（MMSE）评分、POCD发生情况等。【结果】两组OLV时间、出血量等相比较差异均无显著性（ P ＞00．5）；观察组术后与术前MMSE评分比较差异无显著性（ P ＞00．5），对照组术后1 d、3 d MMSE评分较术前明显降低（P ＜00．5）；观察组术后1d、3d患者MMSE评分分别为（264．0±21．6）分和（267．2±20．1）分，明显高于对照组，且差异有显著性（ P ＜00．5）；观察组术后1 d、3 d患者POCD发生率分别为125．0％，25．0％，均明显低于对照组的323．5％和205．9％，且差异有显著性（ P ＜0．05）。【结论】Dex 能有效降低食管癌全身麻醉术中 OLV 患者POCD的发生，值的在临床推广。

Effects of Dexmedetomidine on Early Postoperative Cognitive Dysfunction in Esophageal Cancer Pa-tients with One Lung Ventilation During General Anesthesia Surgery

Objective]To investigate the effects of Dexmedetomidine (Dex) on early postoperative cognitive dysfunc‐tion(POCD)in esophageal cancer patients with one lung ventilation(OLV) during general anesthesia surgery .Methods]Seventy‐four patients with esophageal cancer surgery from March 2014 to December 2015 were selected and randomly di‐vided into observation group ( n =40) and control group ( n =34) .The patients in the observation group were intrave‐nously injected with Dex after the induction of anesthesia ,while patients in the control group were intravenously injected with normal saline after the induction of anesthesia .Mini‐mental state examination (MMSE) score and POCD were evalu‐ated in both groups .Results]The OLV time ,bleeding volume ,and other surgical conditions were not statistically signif‐icant between the two groups ( P >0 0.5) .The preoperative and postoperative MMSE scores of the observation group were not statistically significant ( P >0 0.5) ,while in the control group ,the postoperative 1d and 3d MMSE scores were significantly lower than the preoperative score ( P <0 0.5) .The observation group postoperative 1d ,3d MMSE scores were (26 4.0 ± 2 1.6) points and (26 7.2 ± 2 0.1) points ,significantly higher than those of the control group ( P <0 0.5);The observation group postoperative 1d and 3d POCD incidence rates were 12 5.0% and 2 5.0% ,significantly lower than the 32 3.5% and 20 5.9% rates ,respectively ,of the control group .The difference was statistically significant ( P <0 0.5) .Conclusion]Dexmedetomidine will be able to effectively reduce the postoperative occurrence of POCD in esophageal canc‐er surgery patients with OLV during general anesthesia and is worthy of promotion .