Objective To explore the effect of dexmedetomidine on cognitive impairment after heart valve surgery in older patients. Methods 155 older patients undergoing heart valve replacement surgery form June 2013 to December 2016 were selected. According to the sequence of surgery, the patients were divided into dexmedetomidine group and saline control group. The contents of Ca-vO2, SjvO2, COER, plasma brain injury markers MBP and NSE were compared between the two groups before anesthesia induc-tion (T0), when ascending aorta was opened ( T1), at the end of cardiopulmonary bypass ( T2) and 6 h after surgery ( T3). MMSE was used to evaluate the cognitive function 1 day before and 7 days after surgery. Results There were no significant differ-ences in Ca-vO2, SjvO2, COER, MBP and NSE between the two groups at T0 (P>0.05). At the time of T1 and T2, the levels of SjvO2 and COER were significantly higher (P0.05), while the contents of MBP and NSE in the dexmedetomidine group were significantly lower than those in the control group (P0.05), while the MMSE score in dexmedetomidine group was significantly higher than that in the control group ( P 0.05) ; T1 和T2 时, 右美托咪定组患者SjvO2 和 COER 均显著高于对照组 ( P 0.05), 而右美托咪定组MBP 和 NSE 含量却显著低于对照组 ( P 0.05) , 而与对照组相比, 差异有统计学意义 ( P<0.05), 且认知功能障碍发生率显著低于对照组 (P<0.05).结论 右美托咪定可以通过降低心脏瓣膜手术过程中脑氧的消耗量降低患者脑损伤, 而降低患者术后认知功能障碍的发生率.
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