术前小剂量地塞米松对老年患者术后谵妄的影响

发表时间：2014-06-05 浏览次数：1406次

引用：

周岩；王东信；史成梅.术前小剂量地塞米松对老年患者术后谵妄的影响[J].临床麻醉学杂志,2013,29(03):219-221

关键词：

外科重症患者术后谵妄血清皮质醇地塞米松

作者：

周岩；王东信；史成梅；

作者单位：

北京大学第一医院麻醉科；

出版年份：

2013

期刊页数：

219-221

收录者：

知网,万方

摘要：

观察术前小剂量地塞米松对老年患者非心脏手术术后谵妄的影响.方法选择212例老年择期全身麻醉非心脏手术患者,随机均分为地塞米松组和对照组.地塞米松组患者诱导前静注地塞米松10 mg,对照组静注生理盐水2 ml.术后1周内每天定期对患者评估护理谵妄筛选评分(Nu-DESC),记录谵妄的发生率和持续时间.术后第1天8:00AM抽取动脉血测定血清皮质醇浓度.结果谵妄发生率和持续时间地塞米松组为45例(42.5％)和(3.7±3.0)d,对照组为54例(50.9％)和(4.4±2.8)d,两组谵忘发生率和持续时间差异无统计学意义.术后第1天血清皮质醇浓度地塞米松组为(114.9±101.9)μg/L,明显低于对照组的(166.3±107.2)μg/L(P＜0.01)；发生谵妄的患者血清皮质醇浓度地塞米松组为(168.8±120.6) μg/L；对照组为(208.4±108.0)μg/L;未发生谵妄的患者血清皮质醇浓度地塞米松组为(65.9±41.3) μg/L,对照组为(111.2±77.7) μg/L,两组发生谵妄的患者血清皮质醇浓度均明显高于未发生谵妄的患者,且发生或未发生谵妄的地塞米松组血清皮质醇浓度明显低于对照组(P＜0.05或P＜0.01).结论老年患者全身麻醉下非心脏手术术前静注10mg地塞米松,不能降低术后谵妄发生率与持续时间,但似可降低谵妄发生患者的血清皮质醇浓度增幅.未发生术后谵妄的患者术后血清皮质醇浓度降低. Effects of IOw does of PR ← operative deXall1eth ε usOIle on de II Rmn and ser [llll corticol leveI in aged pati α receivi11g Il], n ω MHC surge at the zHOu|'1 "", l 1 Lp, RE 冫 Terrier Terrier 冫 Do heart, J mud, 1r1Lr c/ze "from the A0 DeuJr/ /,,, eJl r the A" Si SR nine - FI o`.gy, f Ⅱ - thanks to R said. J the milk PI J knife Gu "San V called bog San ry, help Ding San Jzg] 0 ∞ 3 people, J CorF called Xi Xi of this knife? "Idj/lg CLR or: zHOt/ γ l silicon is /l, E" in its ": Z don't oI/, if the'lJlora@ l OO co knife, C knife [Abs, 9z," ACD o, ect e Toinv e the influence of ∞ TIG shield L ° w dose of PR per on post-operative dehrum ← degrees offered and serum corticol level in patients underg ing n ° NIethods ° Tv/ ° hundred and twelve aged patients undergoing n anesthesia were randol divided △ lIy ° int ° T V /o groups: dexamethas ne group and contr ° L ° gr ° dexamethas ° ne group, patients were given 10 mg of before the induction dexamethas ° ne ° anesthesia, wh operation. Everyday and after the operati ° n, each patient V à screenil △ G Scale (Nu - DES3) to measure the incidence of dehriun △ Resul The incidence of delirium, group, and its Duratlon were45 (42.5%) and (3.7 ± 3.o) ∞ ntrol g ∞ up w love 54 (50.9%) and (4.4 ± 2.8) d; TL △ e cortic ° was (1, serum. 9 + 1o1.9) ug/I, and (166.3 ± 107.2) ug/I, in the C ntrol group (P< (0.01).

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