摘要
目的探讨老年顽固性失眠应用右美托咪定诱导睡眠平衡术对患者睡眠质量、认知功能的影响。方法纳入河南大学第一附属医院2022年1月至2023年1月收治的老年顽固性失眠患者70例作为此次研究的对象,以随机数字表法作为分组依据,分为A组(丙泊酚诱导)、B组(右美托咪定诱导),各35例,均接受睡眠平衡术,连续治疗3 d为1个疗程,共治疗3个疗程。比较两组治疗前、治疗3个疗程后睡眠过程、匹兹堡睡眠质量指数(PSQI)、过度觉醒量表(HAS)评分、认知功能,治疗3个疗程后临床疗效,不同时间点血清皮质醇水平。结果治疗3个疗程后,与A组临床总有效率比较,B组更高;与治疗前进行比较,治疗3个疗程后两组总记录及睡眠时间均延长,且B组长于A组,睡眠潜伏期、觉醒时间均缩短,且B组短于A组,觉醒次数均减少,且B组少于A组,PSQI、极限个数总和、自省因子、反应因子各项评分均降低,且B组低于A组,简易精神状况检查(MMSE)评分均升高,B组高于A组;与治疗前进行比较,治疗1~3个疗程后两组血清皮质醇水平均逐渐降低,且B组低于A组(P<0.05)。结论老年顽固性失眠应用右美托咪定诱导睡眠平衡术能够有效缓解患者过度觉醒情况,优化其睡眠过程,同时还能够改善患者因失眠引起的认知功能损害,从而提高其认知功能以及睡眠质量,且疗效显著。
Objective Exploring the effects of dexmedetomidine induced sleep balance surgery on sleep quality and cognitive function in elderly patients with refractory insomnia.Methods Seventy elderly patients with intractable insomnia admitted to the First Affiliated Hospital of Henan University from January 2022 to January 2023 were selected as the research objects.They were randomly divided into the group A(induced by propofol)and the group B(induced by dexmedetomidine),with 35 cases in each group,and all of them received sleep balance surgery.Three days of continuous treatment was a course of treatment,with a total of three courses of treatment.The sleep process,score of Pittsburgh sleep quality index(PSQI),score of hyperarousal scale(HAS),cognitive function,clinical efficacy after 3 courses of treatment and serum cortisol levels at different time points were compared between the two groups.Results After 3 courses of treatment,compared with the total clinical effective rate in the group A,group B was higher.Compared with before treatment,after 3 courses of treatment,the total record and sleep time of the two groups prolonged,and the group B was longer than the group A.The sleep latency and awakening time shortened,and the group B was shorter than the group A.The awakening times reduced,and the group B was less than the group A.The score of PSQI,the sum of limit numbers,introspection factors and response factors all decreased,and the scores of mini-mental examination(MMSE)in the group B were lower than those in the group A,while those in the group B were higher than those in the group A.Compared with before treatment,the serum cortisol levels in the two groups decreased gradually after 1-3 courses of treatment,and the group B was lower than the group A(P<0.05).Conclusion The application of dexmedetomidine induced sleep balance surgery in elderly patients with refractory insomnia could effectively alleviate excessive arousal,optimize their sleep process,and improve cognitive impairment caused by insomnia,thereby improving their cognitive function and sleep quality,with significant therapeutic effects.
作者
张晗
毛珊珊
李萌
陈勇
ZHANG Han;MAO Shanshan;LI Meng;CHEN Yong(Department of Anesthesia and Perioperative Medicine,the First Affiliated Hospital of Henan University,Kaifeng 475100,China)
出处
《河南医学研究》
2025年第4期615-619,共5页
Henan Medical Research
基金
开封市科技发展计划项目(2203025)。
关键词
失眠
顽固性
老年
右美托咪定
睡眠平衡术
睡眠质量
认知功能
insomnia
stubbornness
old age
dexmedetomidine
sleep balance surgery
sleep quality
cognitive function
