摘要
目的探讨帕瑞昔布钠联合舒芬太尼对髋关节置换术患者术后认知功能及炎性反应的影响。方法选取医院2016年5月至2018年2月收治的患者131例,随机分为对照组(65例)和观察组(66例)。两组患者均完成术前准备,观察组患者在手术切皮前0. 5 h用0. 9%氯化钠注射液将注射用帕瑞昔布钠40. 0 mg稀释至5. 0 m L后肌肉注射,8 h后再次静脉注射20. 0 mg,对照组患者于手术切皮前0. 5 h用0. 9%氯化钠注射液将舒芬太尼20 mg稀释至5. 0 m L后肌肉注射。术后均立即予以静脉自控镇痛。结果术后,两组患者各时间点白细胞介素6(IL-6)、术后12 h肿瘤坏死因子-α(TNF-α)水平均低于对照组(P <0. 05);术后12 h肾上腺素水平及6 h和12 h皮质醇水平均高于对照组(P <0. 05);观察组术后第1天、第3天,简易智力状态检查量表(MMSE)认知功能评分高于对照组,而认知功能障碍发生率低于对照组(P <0. 05);两组患者不良反应发生率比较无明显差异(χ~2=0. 001,P> 0. 05)。结论帕瑞昔布钠联用舒芬太尼能有效减轻髋关节置换术后患者的体内炎性反应,降低肾上腺素及皮质醇水平,改善患者术后认知功能及预后,安全性较高。
Objective To investigate the effect of parecoxib sodium combined with sufentanil on cognitive function and inflammatory reaction in patients undergoing hip replacement.Methods Totally131patients admitted to our hospital from May2016to February2018were selected and randomly divided into the control group(65cases)and the observation group(66cases).Preoperative preparation was completed in both groups.At0.5h before skin incision,the patients in the observation group were injected intramuscularly with40.0mg Parecoxib Sodium for Injection,which diluted to5.0mL by0.9%Sodium Chloride Injection,after8h,20.0mg Parecoxib Sodium for Injection was injected intravenously again.At0.5h before skin incision,the patients in the control group were injected intramuscularly with20.0mg sulfentanyl,which diluted to5.0mL by0.9%Sodium Chloride Injection.Patient-controlled intravenous analgesia was given immediately after operation.Results After operation,the levels of interleukin-6(IL-6)at different time points and tumor necrosis factor-α(TNF-α)at postoperative12h in the observation group were lower than those in the control group(P<0.05).The levels of adrenaline at postoperative12h and the levels of cortisol at postoperative6h and12h in the observation group were higher than those in the control group(P<0.05).On the postoperative1st and3rd day,the cognitive function score of mini-mental state examination(MMSE)in the observation group was higher than that in the control group,while the incidence rate of cognitive dysfunction in the observation group was lower than that in the control group(P<0.05).There was no significant difference in the incidence rate of adverse reactions between the two groups(χ^2=0.001,P>0.05).Conclusion Parecoxib sodium combined with sufentanil can effectively alleviate the inflammatory reaction,reduce the levels of adrenaline and cortisol,improve the cognitive function and prognosis of patients undergoing hip replacement,and it is safe.
作者
叶绍兵
代娟
陈强
YE Shaobing;DAI Juan;CHEN Qiang(Department of Anesthesia,The Third Affiliated Hospital of Army Medical University,Field Surgery Research Institute,Chongqing,China400042)
出处
《中国药业》
CAS
2019年第1期45-47,共3页
China Pharmaceuticals
基金
重庆市科技计划项目[cstc2016shmszx40034]
关键词
帕瑞昔布钠
舒芬太尼
髋关节置换术
术后认知功能
炎性反应
parecoxib sodium
sufentanil
hip replacement
postoperative cognitive function
inflammatory reaction
