本刊首页 > 期刊目次 > 帕瑞昔布钠联合舒芬太尼对老年骨科手术后认知功能及炎性反应的影响

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帕瑞昔布钠联合舒芬太尼对老年骨科手术后认知功能及炎性反应的影响

  • 付刚

* 通信作者: 付刚, 单位:中华人民解放军八十三军医院麻醉科

摘要

【摘要】
目的 探讨帕瑞昔布钠联合舒芬太尼对老年骨科手术后认知功能及炎性反应的影响。

方法 本研究对象为我院2019年1月~2020年1月100例老年骨科手术患者,随机分为对照组与观察组,对照组采用舒芬太尼常规麻醉,观察组在对照组基础上联合使用帕瑞昔布钠。比较术前、术后3h、24h、3d血清肿瘤坏死因子-α(TNF-α)、白细胞介素6(IL-6)水平,并同时采用简易智力状态检查量表(MMSE)评估患者认知功能,并比较认知功能障碍发生率。

结果 两组术后TNF-α、IL-6水平均显著高于术前,但术后逐渐降低,观察组术后3h、24h血清 TNF-α、IL-6水平显著低于对照组,(P<0.05),术后3d组间比较差异无统计学意义(P>0.05);两组术后MMSE评分低于术前,且术后逐渐升高,术后3h、24h观察组显著高于对照组,(P<0.05),术后3d组间比较差异无统计学意义(P>0.05);观察组认知功能障碍发生率显著低于对照组,(P<0.05)。

结论 帕瑞昔布钠联合舒芬太尼能显著降低老年骨科手术后认知功能障碍发生率,并降低术后早期炎性反应程度。

关键词:关键词:帕瑞昔布钠;舒芬太尼;老年骨科手术;认知功能;炎性反应

ABSTRACT

[Abstract]
Objective To investigate the effects of parecoxib sodium combined with sufentanil on cognitive function and inflammatory responses after orthopedic surgery in elderly patients.

Methods A total of 100 elderly patients undergoing orthopedic surgery in our hospital from January 2019 to January 2020 were selected in this study and randomly divided into the control group and the observation group. The control group were given sufentanil based general anesthesia, and the observation group was given parecoxib sodium based on the control group. Serum levels of tumor necrosis factor - α (TNF - α), interleukin 6 (IL-6) were compared preoperatively, 3 h, 24 h, and 3 d after surgery, and the mini mental state examination (MMSE) was also used to assess cognitive function, and the incidence of cognitive dysfunction was compared.

Results The levels of TNF - α and IL-6 in the two groups were significantly higher than before surgery, but gradually decreased after surgery, and the serum levels of TNF - α and IL-6 in the observation group were significantly lower than those in the control group at 3 h and 24 h after surgery (P< 0.05).There was no significant difference between groups 3 d after surgery (P> 0.05).The MMSE scores of the two groups were lower than those of the preoperative and gradually increased after surgery, and were significantly higher than those of the control group when observed at 3 h and 24 h after surgery (P< 0.05).There was no significant difference between groups 3 d after surgery (P > 0.05).The incidence of cognitive dysfunction in the observation group was significantly lower than that in the control group (P< 0.05).

Conclusion   Parecoxib sodium plus sufentanil significantly reduced the incidence of cognitive dysfunction and reduced the degree of early postoperative inflammatory response in elderly patients undergoing orthopedic surgery.

Key words: Key words Parecoxib Sodium; Sufentanil; Geriatric Orthopedic Surgery; Cognitive Function; Inflammatory Response

引用本文 / How to Cite This Article

付刚.帕瑞昔布钠联合舒芬太尼对老年骨科手术后认知功能及炎性反应的影响[J]. 国际精神病学杂志, 2021, 48(4): 726-729

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