摘要
目的观察氢吗啡酮联合帕瑞昔布对老年患者胸腔镜下肺癌根治术后认知功能的改变情况。方法采用随机数表法将120例接受胸腔镜下肺癌根治术的老年患者随机分成4组,氢吗啡酮组(H组)、帕瑞昔布组(P组),联合组(U组)和对照组(C组)4组,每组30例。P组和U组患者手术前20分钟静脉注射40 mg帕瑞昔布,H组和U组患者手术结束前15分钟注射10μg/kg的氢吗啡酮,C组注入生理盐水。在手术前的第1天和手术后的第7天采用简易精神状态检查表(MMSE)对认知功能进行评估。在术中采集患者外周血检测IL-6和TNF-α。结果与术前1天相比,4组患者术后第7天MMSE评分显著下降(P<0.05);U组POCD的发生率低于C组(P<0.05),P组与C组之间、H组与C组之间POCD的发生率没有统计学差异(P>0.05)。U组患者手术结束后IL-6和TNF-α的水平明显低于对照组(P<0.05);P组与C组之间、H组与C组之间IL-6和TNF-α水平差异没有统计学差异(P>0.05)。结论氢吗啡酮联合帕瑞昔布对老年患者胸腔镜下肺癌根治术后认知功能具有保护作用。
Objective To observe the effect of hydromorphone combined with parecoxib on cognitive function in elderly patients after thoracoscopic radical resection of lung cancer.Methods 120 elderly patients underwent thoracoscopic radical resection of lung cancer were randomly divided into 4 groups:hydromorphone group(H group),parecoxib group(group P),combination group(Group U)and control group(Group C),with 30 cases in each group.40 mg parecoxib was injected intravenously 20 minutes before operation in group P and U,10μg/kg hydromorphone 15 minutes before the end of operation in group H and U,and saline was injected into group C.Results Compared with the first day before operation,the MMSE score of the four groups on the seventh day after operation decreased significantly(P<0.05);the incidence of POCD in group U was lower than that in group C(P<0.05);there was no significant difference in the incidence of POCD between group P and group C,between group H and group C(P>0.05);the levels of IL-6 and TNF-αin group U after operation were significantly lower than those of the control group(P<0.05),and there was no significant difference in the incidence of IL-6 and TNF-αbetween group P and group C,between group H and group C,There was no significant difference in the levels of TNF-αand 6(P>0.05).Conclusion Hydromorphone combined with parecoxib has a protective effect on cognitive function of elderly patients after thoracoscopic radical resection of lung cancer.
作者
杨雪
栗付民
韩灵龙
YANG Xue;LI Fumin;HAN Linglong(Xuchang Central Hospital,Xuchang,461000)
出处
《实用癌症杂志》
2021年第11期1887-1889,1900,共4页
The Practical Journal of Cancer
基金
2019年度河南省医学科技攻关计划联合共建项目(编号:LHGJ20191380)。
关键词
氢吗啡酮
帕瑞昔布
术后认知功能障碍
胸腔镜下肺癌根治术
老年人
Hydromorphone
Parecoxib
Postoperative cognitive dysfunction
Thoracoscopic radical resection of lung cancer
Elderly
