小剂量右美托咪定对老年髋部骨折术后血流动力学的影响

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Abstract Objective To observe the effect of low-dose dexmedetomidine on hemodynamics in elderly patients with hip fracture.Methods Elderly patients with hip fracture treated in the intensive care unit (ICU) of Beijing Jishuitan Hospital from July 2020 to August 2021 were enrolled.The age ranged from 74 to 97 years，with an average of (87.5±6.8)years.The operative methods included total hip arthroplasty in 14 cases，hemiarthroplasty in 24 cases and intramedullary nail fixation in 76 cases.114 patients were randomly divided into dexmedetomidine group and control group.After entering ICU，the dexmedetomidine group was given dexmedetomidine 0.1 μg/kg per hour，and the control group was given 0.9% saline 0.025 mL/kg per hour.The patients were observed until 8 o'clock of the next day and drug administration stopped the.There were 56 cases in dexmedetomidine group，including 25 males and 31 females.The age ranged from 74 to 96 years，with an average of (83.2±5.2)years.There were 58 cases in the control group，including 27 males and 31 females.The average age was (84.4±6.8) years.Non invasive cardiac output monitoring(nicom) was used for hemodynamic monitoring.The changes of hemodynamic parameters in the two groups(cardiac output index，stroke volume index，mean arterial pressure，systolic blood pressure，diastolic blood pressure，heart rate，lactic acid)and the incidence of delirium，length of stay in ICU，in-hospital mortality and postoperative complications were observed.Results There was no significant difference in postoperative cardiac index，stroke volume index，mean arterial pressure，arterial systolic pressure，arterial diastolic pressure，heart rate and lactic acid (P＞0.05).There was no significant difference in the proportion of hypotension and bradycardia (P＞0.05).The incidence of delirium in the dexmedetomidine group was significantly lower than that in the control group (P＝0.048).The incidence of hypertension in dexmedetomidine group was significantly lower than that in the control group (P＝0.006).There was no significant difference in average hospital stay and postoperative complications (P＞0.05).Conclusion Continuous pumping of low-dose dexmedetomidine in elderly patients with hip fracture in ICU can effectively reduce the incidence of delirium and postoperative hypertension，and has no significant effect on hemodynamic parameters.

Key words： elderly patients hip fracture dexmedetomidine hemodynamic delirium

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	Cui Zhen
	Tong Mengqi
	Yu Miaomiao
	Bai Ying *

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Cui Zhen,Tong Mengqi,Yu Miaomiao, et al. Effect of Low-Dose Dexmedetomidine on Postoperative Hemodynamics in Elderly Hhip Fractures[J]. sygkzz, 2022, 27(2): 126-130.

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http://www.sygkzz.com/EN/ OR http://www.sygkzz.com/EN/Y2022/V27/I2/126

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