| Objective: Dexmedetomidine care microphones on postoperative cognitive function changes of patients with fracture and analysis of all relevant factors would affect the mini-mental state examination(mini-mental state examination,MMSE)score.Methods: Collect affiliated Zhong Shan hospital of Da Lian university of shipbuilding division October 2016 to December 2016 in 42 patients with fracture surgery.Inclusion criteria: age ? 18 years of age and not more than 70 years;American Society of Anesthesiologists(American Society of anesthesiologyists,ASA)grade I-IIlevels;patients ' informed consent and signed informed co nsent.Excluded standard: 1.has had cognitive function obstacles of patients;2.obviously cardiovascular system,and respiratory,and liver kidney disease,and central nervous system,and or muscle disease history;3.in selected before of 3 months within taking other experiment drug or participation has other clinical experiment;4.surgery related history;5.taking related drug,and listening,and language obstacles,and brain disease history;6.patients refused to or family not tie survey.Routine preoperative intravenous pump in patients with dexmedetomidine care to maintain sleep,when necessary,loading needed additional other adjuvants;20-30 min before withdrawal.Using MMSE on cognitive function in patients with determination.Observation patients in operation before,and operation after 24 h,and operation after 48 h of MMSE of score,dexmedetomidinefrom the right microphone fixed dosage,duration of surgery,anesthesia,patient age,gender,parts of the surgery,postoperative analgesia pump used,history of education,or alcohol,whether smokers affectation record operation history,and so on and to explore whether there is a correlation.Clinical data collected using EXC EL 2007 for finishing,SPSS17.0 used in statistical analysis.Numerical analysis of variable data results to "mean ± standard deviation" form,number of results of analysis of categorical variable data to(or/and%).Two sets of comparison between numerical variable data in accordance with the experimental design used paired sample t test or analysis independent samples t-test;multiple sets of numerical comparison of variable data using ANOVA method has completed processing,if the comparison results show differences between the groups,you use LSD do 22 comparative analysis.Comparison of categorical variable data according to the characteristics of the material itself has used C hi-square test or Fisher exact probability analysis method.All statistical results with P<0.05 used as a criterion of statistical significance difference.Results: Dexmedetomidine supporting meters set for clinical fracture trauma patients,from dexmedetomidine supporting meters set dosage,and surgery long,and anesthesia way,and patients age,and gender,and surgery parts,and operation after analgesic pump of using,and education,and whether has drinking history,and whether has smoking history,and whether has surgery history,aspects compared,which through MMSE score and operation before compared,declined 2 points or 2 points above for positive.Research results displayed:(1)a,through on dexmedetomidine supporting meters set dosage,and surgery long,and anesthesia way,and age,and gender,and surgery parts survey displayed: dexmedetomidine dosage for 0-10 ml of patients in the is positive of cases for 0 cases,accounted for the classification of 0%,10-20 ml of patients in the is positive of cases for 1 cases,accounted for the classification of 4.76%,20-30 m L of disease patient in the is positive of cases for 1 cases,accounted for the classification of 10.00%,30 m L above of patients in the is positive of cases for 1 cases,Accounted for the classification of 33.33%;surgery time length for 0-45 min of patients in the is positive of cases for 0 cases,accounted for the classification of 0%,45-90 min of disease patient in the is positive of cases for 2 cases,accounted for the classification of 15.38%,90-135 min of patients in the is positive of cases for 1 cases,accounted for the classification of 12.5%,135 min above of patients in the is positive of cases for 0 cases,accounted for the classification of 0%;body anesthesia way patients in the is positive of cases for 0 cases,Accounted for the anesthesia way of 0%,arm bundle neural block patients in the is positive of cases for 1 cases,accounted for the a ge paragraph of 14.29%,CSEA patients in the is positive of cases for 2 cases,accounted for the age paragraph of 7.69%;age 18-30 age age paragraph patients in the is positive of for 1 cases,accounted for the age paragraph of 14.29%;30-50 age age paragraph in the is positive of for 2 cases,accounted for the age paragraph of 11.76%,50-70 age age paragraph in the is positive of for 0 cases,accounted for the age paragraph of 0%;Male patients in the is positive of for 1 cases,accounted for male patients of 5%,women patients in the is positive of for 2 cases,accounted for women patients 10.53%;male patients in the is positive of for 1 cases,accounted for male patients of 5%,women patients in the is positive of for 2 cases,accounted for women patients 10.53%;upper limb surgery patients in the is positive of cases for 1 cases,accounted for the surgery parts of 7.69%,lower limb surgery patients in the is positive of cases for 2 cases,accounted for the surgery parts of 7.69%;B through analgesic pump of application,and education,and drinking history,and smoking history,and surgery history survey displayed: operation after using analgesic pump of patients in the is positive of cases for 3 cases,accounted for the classification of 12.5%,no using analgesic pump of disease patient in the is positive of cases for 0 cases,accounted for the classification of 0%;in education compared in the,University culture in the is positive patients for 0 cases,accounted for the education of 0%,high school culture patients in the is positive of for 1 cases,accounted for the education of 9.09%,Junior high in patients with culture-positive for 2,16.67% of total literacy,primary school in patients with culture-positive for 0,and 0% of total education;no alcohol consumption and positive case is 0.Accounted for the classification of 0%,has drinking history and is positive cases for 3 cases,accounted for the classification of 9.37%;no smoking history and is positive cases for 0 cases,accounted for the classification of 0%,has smoking history and is positive cases for 3 cases,accounted for the classification of 10.71%;has surgery history and is positive cases has 2 cases,accounted for the classification of 10.53%,no surgery history and is positive cases has 1 cases,accounted for the classification of 5.00%.Through statistical analysis of the results showed no significant P>0.05.(2)patients with preoperative and postoperative MMSE comparison of 24-hour,48-hour,SPSS17.0 statistical software,database and statistical analysis.Group compared with its paired t-test,P<0.05,shows before and after 24 hours,48 hours after the surgery there were significant mean differences between 22.MMSE24,MMSE48 in postoperative patients with preoperative MMSE0 points representing an increase,on the postoperative MMSE48 score MMSE24 score.(3)used multiple linear return method study has age,and gender,and height,and weight,and minority or not,and education,and smoking history,and drinking history,and past surgery history,and past history,and injured parts,and anesthesia way,and dexmedetomidine dosage,and auxiliary medication,and surgery time,and anesthesia time,and liquid into volume,and whether using pain pump,and whether headache,index a,: and MMSE0 h before of return relationship,through stepwise method on their variable for screen except found,age,and Past surgery history,2 a index and MMSE0 h is closely related to,specific reasons stay discussion;b: and MMSE24 h of return relationship,education,and drinking history,2 a index and MMSE24 h is closely related to,c: and MMSE48 h of return relationship,MMSE24 h,and age and MMSE48 h of return relationship exists,description in 24 h on patients for MMSE test after,for follow-up 48 h again do same of test has tips role,Improved MMSE score.Conclusion:(1)This observation dexmedetomidine has not seen adverse effects on postoperative cognitive function in patients undergoing elective trauma orthopedic surgery;(2)education and MMSE score pairs the effects of elective trauma on patients undergoing surgical procedures;(3)Some patients have a "learning effect" on the evaluation system of postoperative cognitive impairment.That is,the late observation of the content of each assessment point of the prior to the operation of memory,familiarity and understanding,the results may have a "positive ascension" effect. |
PDF Full Text Request