术前应用戊乙奎醚对老年病人术后早期认知功能的影响 疏树华 潘建辉.doc

术前应用戊乙奎醚对老年病人术后早期认知功能的影响 疏树华 潘建辉 方才 王瑞明 谢志琼 〔摘要〕 目的 观察术前应用戊乙奎醚(商品名:长托宁)对老年全麻病人非心脏手术后早期认知功能障碍发生率的影响，为老年病人术前安全用药提供理论依据。方法：选择择期全麻下行非心脏手术且年龄≥65岁的老年病人120例，ASAⅠ～Ⅲ。随机分成三组，A组（长托宁组），B组（阿托品）采用简易智力状态检查（MMSE）评估病人认知功能全身麻醉SHU Shu-hua, PAN Jian-hui, FANG Cai, WANG Rui-ming, et al. Department of Anesthesiology, The Provincial Hospital Affiliated to Anhui Medical University, Hefei 230001,China 【Abstract】 Objective TO observe the effect of penehyclidine hydrochloride on cognitive dysfunction early after noncardiac surgery in elderly patients under general anesthesia so as to provide the theoretical basis as preoperative medication. Methods 120 patients older than 65 years and scheduled for selective noncardiac surgery and general anesthesia, were randomly divided into three groups: group A 基金项目：安徽省卫生厅临床医学重点学科应用技术项目（编号：05A026） 作者单位：230001 合肥市 安徽医科大学附属省立医院麻醉科 (penehyclidine hydrochloride),group B (scopolamine) and roup C (atropine).Each group included forty patients. And intramuscular injection of penehyclidine hydrochloride 0.5mg, atropine 0.5mg or scopolamine 0.3mg , were made respectively thirty minutes before anesthesia. SBP、DBP、HR SpO2 were recorded before injection, at l,10、20、30min after injection and 1min postintubation .The cognitive function of all the patients was evaluated by MMSE at pre-operation and 24 hour, 48 hour, 72 hour after-operation. Results The incidence of POCD in group A,group B and roup C was 10patients、11patients and12patients in three days post-operation, respectively，the incidence rate was 25%、27.5％ and 30％，however there was no significant difference between the three groups（P0.05）.The score of MMSE in group A was higher than those in group B and group C at 24h、48h and 72h after operation, however there was no significant difference between the three groups（P0.05）.Results Preoperative administration of penehyclidine(0.5mg) would not increase the incidence of cognitive dysfunction early after noncardiac surgery in elderly patients.Penehycli