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1、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），C组（东茛菪碱组），组），每组均40例，分别在麻醉前半小时肌注长托宁0.5mg、阿托品0.5mg和东茛菪碱0.3mg，于术前1d及术后24h、48h、72h由同一试验者采用简易智力状态检查法（MMSE）评估病人认知功能。结果：老年患者非心脏手术后3天内
2、A组、B组和C组分别有10例、11例和12例发生POCD，发生率分别为25%、27.5％和30％，三组间差异无统计学意义(P>0．05)。术后24h、48h和72hMMSE评分A组略高于B组和C组但无统计学意义(P>0．05)。结论：术前肌注长托宁0.5mg不增加老年非心脏手术病人POCD发生率，作为术前用药长托宁比东茛菪碱和阿托品更适合用于老年病人。[关键词]戊乙奎醚；老年人；病人；全身麻醉；术后认知障碍Effectofpenehyclidinehydrochlorideoncognitivefunctionearlyaftersurgeryinelderlypatientsunderge
3、neralanesthesia.SHUShu-hua,PANJian-hui,FANGCai,WANGRui-ming,etal.DepartmentofAnesthesiology,TheProvincialHospitalAffiliatedtoAnhuiMedicalUniversity,Hefei230001,China【Abstract】ObjectiveTOobservetheeffectofpenehyclidinehydrochlorideoncognitivedysfunctionearlyafternoncardiacsurgeryinelderlypatientsund
4、ergeneralanesthesiasoastoprovidethetheoreticalbasisaspreoperativemedication.Methods120patientsolderthan65yearsandscheduledforselectivenoncardiacsurgeryandgeneralanesthesia,wererandomlydividedintothreegroups:groupA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(penehyclidinehydroch
5、loride),groupB(scopolamine)androupC(atropine).Eachgroupincludedfortypatients.Andintramuscularinjectionofpenehyclidinehydrochloride0.5mg,atropine0.5mgorscopolamine0.3mg,weremaderespectivelythirtyminutesbeforeanesthesia.SBP、DBP、HRSpO2wererecordedbeforeinjection,atl,10、20、30minafterinjectionand1minpos
6、tintubation.ThecognitivefunctionofallthepatientswasevaluatedbyMMSEatpre-operationand24hour,48hour,72hourafter-operation.ResultsTheincidenceofPOCDingroupA,groupBandroupCwas10patients、11patientsand12patientsinthreedayspost-operation,respectively，theincidenceratewas25%、27.5％and30％，howevertherewasnosig
7、nificantdifferencebetweenthethreegroups（P>0.05）.ThescoreofMMSEingroupAwashigherthanthoseingroupBandgroupCat24h、48hand72hafteroperation,howevertherewasnosignificantdifferencebetweenthethreegroups（P>0.05）.Res
