摘要
目的:探讨地佐辛对骨关节病髋关节置换术(THA)患者术后炎症应激反应及认知功能的影响。方法:选取汉中市中心医院2017年1月至2018年12月收治的97例骨关节病行THA患者,采用随机数字法将其分为观察组(n=49例)对照组(n=48例)。观察组患者术毕前20 min给予地佐辛2.5 mg。对照组患者术毕前20 min给予0.9%氯化钠作为安慰剂。对比术前及术后1h、6h、12h两组白细胞介素(IL-6)、肿瘤坏死因子-α(TNF-α)水平、肾上腺素及皮质醇水平;于术前、术后1d、3d、7d采用简易智力精神状态检查量表(MMSE)对所有患者认知功能进行评定并行组间比较,记录两组不良反应发生情况。结果:术前两组IL-6、TNF-α水平差异无统计学意义(P>0.05),观察组术后1h、6h、12h IL-6水平、术后12h TNF-α水平低于对照组,差异均有统计学意义(P<0.05)。术前两组肾上腺素及皮质醇水平差异无统计学意义(P>0.05),观察组术后12h肾上腺素及术后6h、12h皮质醇水平低于对照组,差异均有统计学意义(P<0.05)。术前及术后7d两组MMSE评分差异无统计学意义(P>0.05),观察组术后1d及3d MMSE评分明显高于对照组,差异均有统计学意义(P<0.05)。两组不良反应发生率差异无统计学意义(P>0.05)。结论:地佐辛可显著降低骨关节病患者行THA术后炎症因子水平,改善术后应激状态,保护患者认知功能,且患者安全耐受,具有一定的临床应用价值。
Objective:To investigate effects of dezocine on postoperative inflammatory stress response and cognitive function in patients with bone and joint disease undergoing total hip arthroplasty(THA).Methods:97 cases of bone and joint disease patients undergoing THA from January 2017 to December 2018 who were treated in Hanzhong Central Hospital were selected.The patients were divided into the observation group(n=49)and the control group(n=48)according to random number table.The observation group were given dezocine 2.5 mg 20 min before operation,while the control group were given 0.9%sodium chloride as a placebo.The levels of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),adrenaline and cortisol were compared before and 1h,6h,12h after operation.Simple Mental State Examination Scale(MMSE)was used to assess the cognitive function of all patients before operation,1d,3d and 7d after operation,and the results were compared between groups.The incidence of two groups of adverse reactions were recorded.Results:There were no significant differences in the levels of IL-6 and TNF-αbetween the two groups before operation(P>0.05).The levels of IL-6 and TNF-αat 1h,6h,12h after operation in the observation group were lower than those in the control group,the difference was statistically significant(P<0.05).There were no significant differences in adrenaline and cortisol levels between the two groups before operation(P>0.05).The level of adrenaline at 12h after operation and cortisol at 6h and 12h after operation in observation group were significantly lower than those in control group,the differences were statistically significant(P<0.05).There was no significant difference in MMSE score between the two groups before and on the 7d after operation(P>0.05),while the MMSE score of the observation group on the 1d and 3d after operation was significantly higher than that of the control group,the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the
作者
李雪丹
黄柯冰
黄杰
陈志惠
魏凯
LI Xue-dan;HUANG Ke-bing;HUANG Jie;CHEN Zhi-hui;WEI Kai(Department of Operation Anesthesiology,Hanzhong Central Hospital of Shaanxi Province,Hanzhong,Shaanxi,723000,China;Department of Anesthesiology,Hubei Maternal and Child Health Hospital,Wuhan,Hubei,430070,China)
出处
《现代生物医学进展》
CAS
2020年第2期342-345,400,共5页
Progress in Modern Biomedicine
基金
陕西省卫生计生委科研基金项目(2015B1106)。
关键词
地佐辛
骨关节病
髋关节置换术
炎症因子
应激状态
认知功能
Dezocine
Bone and joint disease
Total hip arthroplasty
Inflammatory cytokines
Stress state
Cognitive function
