【摘要】 目的探究右美托咪定联合罗哌卡因对老年神经外科颅脑损伤手术患者术后认知功能的影响情况。方法选取2018年9月—2020年7月于神经外科住院治疗并需行外科手术治疗的老年颅脑损伤患者共计164例,患者依据随机数字表法平均分成两组,即观察组与对照组,每组各82例。观察组患者麻醉时采用右美托咪定联合罗哌卡因及利多卡因进行麻醉,对照组采用罗哌卡因联合利多卡因进行麻醉,并于麻醉后即刻（t₁）、麻醉后6 h（t₂）及麻醉后24 h（t₃）测定患者血清中的白细胞介素-6（interleukin-6,IL-6）及皮质醇（cortisol,Cort）浓度水平;运用韦氏成人量表于术前1 d、术后1周比较患者的认知功能情况,采用Z分法确定患者是否存在认知功能障碍（postoperative cognitive dysfunction,POCD）。结果两组患者t₁时间IL-6及Cort浓度间差异无统计学意义（P>0.05）,t₂、t₃时间观察组IL-6及Cort浓度均低于对照组,差异具有统计学意义（P<0.05）;观察组患者术后各时间段POCD发病率均低于对照组,差异具有统计学意义（P<0.05）。结论右美托咪定联合罗哌卡因对神经外科颅脑损伤手术患者术后认知功能恢复有一定帮助,患者恢复更快。更多还原

【Abstract】 Objective To explore the effect of dexmedetomidine combined with ropivacaine on postoperative cognitive function in elderly neurosurgical patients with head injury.Methods Selected 164 elderly patients with head injury from September 2018 to July 2020 who required surgical treatment in the department of neurosurgery.The patients were divided into the observation group and the control group according to the random number table,each with 82 cases.Patients in the observation group were anesthetized with dexmedetomidine combined with ropivacaine and lidocaine during anesthesia,and the control group was anesthetized with ropivacaine combined with lidocaine,measured the serum levels of interleukin-6 （IL-6） and cortisol （Cort） at anesthesia （t₁）,6 h after anesthesia（t₂） and 24 h after anesthesia （t₃）.The Wechsler adult scale was used to compare the cognitive function of patients 1 day before operation and1 week after operation,and the Z-score method was used to determine whether the patient had postoperative cognitive dysfunction （POCD）.Results There was no significant difference in IL-6 and Cort concentrations between the two groups of patients at t₁ （P>0.05）.The IL-6 and Cort concentrations in the observation group at t₂ and t₃ were lower than those in the control group,and the difference was statistically significant （P<0.05）.The incidence of POCD in each subsequent period was lower than that in the control group,and the difference was statistically significant （P<0.05）.Conclusion Dexmedetomidine combined with ropivacaine has certain help for the recovery of cognitive function in patients with neurosurgical craniocerebral injury surgery.更多还原