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目的 研究右美托咪定复合舒芬太尼麻醉对老年全子宫切除术血流动力学及术后认知功能障碍(POCD)的影响,为提高麻醉效果提供临床依据.方法 选择2015年11月-2017年7月在该院被确诊为老年子宫肌瘤行根治术患者100例为研究对象,随机将其分为对照组和观察组,每组各50例,对照组采用舒芬太尼全身麻醉,观察组采用右美托咪定复合舒芬太尼麻醉,对比两组患者围术期血流动力学指标和术后3d的认知功能.结果 两组患者诱导麻醉前(T1)、插管后1 min (T2)、手术开始5 rain (T3)、手术20 min(T4)、拔管前1 min (TS)及拔管后5 min (T6)时间点的平均心率(HR)、氧饱和度(SpO2)、平均动脉压(MAP)和脑电双频谱指数(BIS)值比较差异均无统计学意义(P＞0.05).两组患者平均手术时间和麻醉时间比较差异无统计学意义(P＞0.05),但观察组舒芬太尼用量低于对照组(P＜0.05).术后3d观察组蒙特利尔认知评估量表(MoCA)评分高于对照组,POCD发生率降低(P＜0.05).结论 右美托咪定复合舒芬太尼麻醉在老年全子宫切除术围术期血流动力学较稳定,POCD发生率降低,有较好的应用安全性和有效性.“,”Objective To research the effect of combined anesthesia of dexmedetomidine and sufentanil on hemodynamics and postoperative cognitive dysfunction (POCD) of senile patients undergoing radical hysterectomy,provide a clinical basis for improving anesthetic effect.Methods A total of 100 senile patients diagnosed as uterine fibroids definitely and undergoing radical hysterectomy in Maternal and Child Health Care Hospital of Jiading District from November 2015 to July 2017 were selected and randomly divided into control group and observation group,50 patients in each group.The patients in control group were treated by general anesthesia of sufentanil,and the patients in observation group were treated by combined anesthesia of dexmedetomidine and sufentanil.The hemodynamic indexes during perioperative period and cognitive function at three days after operation in the two groups were compared.Results There were statistically significant differences in heart rate (HR),oxygen saturation (SpO2),mean arterial pressure (MAP),and bispectral index (BIS) before induced anesthesia (T1),at one minute after induced anesthesia (T2),at five minutes after beginning of the operation (T3),at 20 minutes after beginning of the operation (T4),at one minute before extubation (T5),and at five minutes before extubation (T6) between the two groups (P＞0.05).There was no statistically significant difference in the mean operation time and anesthesia time between the two groups (P＞ 0.05),but the dosage of sufentanil in observation group was statistically significantly lower than that in control group (P＜0.05).At three days after operation,MoCA score in observation group was statistically significantly higher than that in control group,while the incidence rate of POCD score in observation group was statistically significantly lower than that in control group (P＜0.05).Conclusion Combined anesthesia of dexmedetomidine and sufentanil used for senile patients undergoing radical hysterectomy during perioperative period can obtain stable hemodynamics,the incidence rate of POCD is low,the safety and effectiveness are high.