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右美托咪定辅助全身麻醉对老年无痛肠镜检查患者血流动力学

及认知功能的影响
Δ

＊
李军利 ，刘楠楠，卢小迎（焦作市第二人民医院麻醉科，河南 焦作 454100）

中图分类号 R971；R969.3 文献标志码 A 文章编号 1001-0408（2024）09-1129-04
DOI 10.6039/j.issn.1001-0408.2024.09.18

摘 要 目的 探讨右美托咪定（DEX）辅助全身麻醉对老年无痛肠镜检查患者血流动力学及认知功能的影响。方法 将2020年7
月至2022年2月在焦作市第二人民医院门诊手术室行无痛肠镜检查的老年患者180例，根据随机数字表法分为对照组（n＝90）和
观察组（n＝90）。对照组患者给予常规全身麻醉（舒芬太尼+丙泊酚麻醉诱导，丙泊酚麻醉维持）；观察组患者在术前准备后加用
DEX辅助全身麻醉。比较2组患者的血流动力学指标[平均动脉压（MAP）、心率（HR）]、全麻用药量、苏醒时间、认知功能[简易精
神状况检查量表（MMSE）]评分、不良反应发生率。结果 2组患者麻醉前（T0）各项指标的差异均无统计学意义（P＞0.05）；与T0
时比较，麻醉10 min后（T1）、肠镜达回盲部（T2）、检查后退镜（T3）、术后10 min（T4）时两组患者的MAP、HR均显著降低，但观察
组患者在T1、T2、T3、T4时的MAP、HR均显著高于对照组（P＜0.05）。与对照组比较，观察组患者的全麻用药量显著降低，苏醒时
间显著缩短，术后 1、2、3 d 的 MMSE 评分显著升高，认知功能障碍发生率及不良反应发生率均显著降低（P＜0.05）。结论
DEX可有效改善老年无痛肠镜检查患者的血流动力学及认知功能，减少全麻用药量，缩短患者苏醒时间，且安全性较好。
关键词 右美托咪定；老年患者；无痛肠镜检查；血流动力学；认知功能；全身麻醉

Effects of dexmedetomidine-assisted general anesthesia on the hemodynamics and cognitive function in
elderly patients undergoing painless enteroscopy
LI Junli，LIU Nannan，LU Xiaoying（Dept. of Anesthesiology， the Second People’s Hospital of Jiaozuo， Henan
Jiaozuo 454100， China）

ABSTRACT OBJECTIVE To investigate the effects of dexmedetomidine （DEX）-assisted general anesthesia on hemodynamics
and cognitive function in elderly patients undergoing painless enteroscopy. METHODS From July 2020 to February 2022， 180
elderly patients undergoing painless enteroscopy in the outpatient operating room of the Second People’s Hospital of Jiaozuo were
selected and divided into a control group （n＝90） and an observation group （n＝90） according to the random number table method.
The control group was given routine general anesthesia （induced with sufentanil and propofol anesthesia， maintained with propofol
anesthesia）， while the observation group was given DEX-assisted general anesthesia after preoperative preparation. The
hemodynamic indexes [mean arterial pressure （MAP）， heart rate （HR）]， dosage of general anesthesia， awakening time， cognitive
function [minimized mental status examination （MMSE）]， and the incidence of adverse drug reactions were compared between the
two groups. RESULTS There was no significant difference in various indicators before anesthesia （T0） between 2 groups （P＞
0.05）. Compared with T0， MAP and HR of the two groups were reduced significantly 10 minutes after anesthesia （T1）， at the time
of enteroscope reaching the ileum and cecum （T2）， enteroscope withdrawal after the examination （T3）， and 10 minutes after
surgery （T4）； but MAP and HR of the observation group at T1， T2， T3， and T4 were all higher than those of the control group
（P＜0.05）. Compared with the control group， the dosage of general anesthesia and the recovery time in the observation group were
significantly reduced or shortened， the MMSE scores at 1， 2 and 3 days after the operation were significantly increased， while the
incidence of cognitive dysfunction and adverse reactions were significantly reduced （P＜0.05）. CONCLUSIONS DEX can
effectively improve the hemodynamics and cognitive function of elderly patients undergoing painless enteroscopy， which is
beneficial to reduce the dosage of general anesthesia， shorten recovery time， and has better safety.
KEYWORDS dexmedetomidine； elderly patient； painless enteroscopy； hemodynamics； cognitive function； general anesthesia

[1]
肠镜检查是诊断肠道疾病的重要方法，可提供直 遍且常规的检查方法 。但肠镜检查为侵入性检查，进
观、高清的图像，并可行活检，故已逐渐成为肠道疾病普 镜、过肠道、退镜等侵入性操作会引起患者血流动力学

波动，不利于检查的顺利完成，也会给患者带来明显的
Δ 基金项目 焦作市科技计划项目（No.20223028）
[2]
不适感 。无痛技术是一种基于麻醉镇痛的辅助检查方
＊第一作者 副主任医师，硕士。研究方向：麻醉学。E-mail：
ljl123456a12@163.com 式，已被应用于肠镜检查中。于肠镜检查前行麻醉处

中国药房 2024年第35卷第9期 China Pharmacy 2024 Vol. 35 No. 9 · 1129 ·