摘要
目的探讨老年髋关节置换术患者在针药复合麻醉下进行手术对其认知功能、心率变异性以及生命体征的影响。方法选择2019年3月—2022年8月本院收治的需进行髋关节置换术的老年患者120例作为研究对象,随机数表法分为对照组和观察组两组,每组各60例。所有患者均由同一手术团队医师进行髋关节置换术,对照组患者接受常规药物麻醉,观察组患者则进行针药复合麻醉,两组患者均持续随访3 d。比较两组患者认知功能,血清神经元特异性烯醇化酶(NSE)以及S-100β水平,心率变异性,心率(HR)、收缩压(SBP)、平均动脉压(MAP),麻醉药物使用剂量,疼痛程度以及不良反应。结果与术前比,术后两组患者MMSE得分呈先降低后升高趋势,但观察组术后1 h、术后24 h MMSE得分均高于对照组,差异具有统计学意义(P<0.05);两组患者血清NSE、S-100β水平均呈先升高后降低趋势,其中观察组血清NSE、S-100β水平手术结束时以及术后24 h均低于对照组,差异具有统计学意义(P<0.05);与术前比,观察组术后3 d SDNN、Trianglar Index水平升高,且高于对照组,差异具有统计学意义(P<0.05);两组患者HR、SBP、MAP水平均呈逐渐升高趋势,其中观察组患者拔管时以及苏醒后HR水平低于对照组;拔管前5 min以及拔管时SBP水平低于对照组,差异有统计学意义(P<0.05);观察组患者手术期间丙泊酚以及瑞芬太尼等麻醉药物的使用剂量均低于对照组,差异具有统计学意义(P<0.05);两组患者VAS评分均呈逐渐降低趋势,且观察组术后6 h、12 h、24 hVAS评分均低于对照组,差异具有统计学意义(P<0.05);观察组不良反应总发生率低于对照组,差异有统计学意义(P<0.05)。结论老年髋关节置换术患者在针药复合麻醉下进行手术能够有效降低血清NSE、S-100β水平,减轻对认知功能的影响,改善心脏的自主神经整合功能,对患者生命体征的影响更小,在减少麻醉药物�
Objective To investigate the effects of combined acupuncture and drug anesthesia on cognitive function,heart rate variability and vital signs of elderly patients undergoing hip replacement.Methods A total of 120 elderly patients requiring hip replacement who were admitted to Changge hospital of traditional Chinese medicine from March 2019 to August 2022 were selected as study subjects and they were divided into the control group and the observation group with 60 cases in each group according to random number table method.All patients underwent hip replacement by physicians of the same surgical team.Patients in the control group received conventional drug anesthesia,and patients in the observation group received combined acupuncture and drug anesthesia.Patients in both groups were followed up for 3 days.Cognitive function,serum neuron-specific enolase(NSE)and S-100β levels,heart rate variability,heart rate(HR),systolic blood pressure(SBP),mean arterial pressure(MAP),anesthetic dose,pain degree,and adverse reactions were compared between the two groups.Results Compared with the preoperative results,the MMSE scores of the two groups decreased first and then increased,but the MMSE scores of the observation group at 1 h and 24 h after the operation were higher than those of the control group,the difference was statistically significant(P<0.05).The levels of serum NSE and S-100β in the two groups firstly increased and then decreased,and the levels of serum NSE and S-100β in the observation group were lower than those in the control group at the end of operation and 24h after operation,the difference was statistically significant(P<0.05).Compared with the preoperative level,the 3d SDNN and Trianglar Index levels in the observation group increased and were higher than those in the control group,and the difference was statistically significant(P<0.05).The levels of HR,SBP and MAP in the two groups showed a gradually increasing trend,and the level of HR in the observation group was lower than that in the control group a
作者
刘勇
Liu Yong(Department of Anesthesiology,Changge Hospital of Traditional Chinese Medicine,Xuchang,Henan 461500,China)
出处
《齐齐哈尔医学院学报》
2023年第12期1116-1120,共5页
Journal of Qiqihar Medical University
关键词
髋关节置换术
针药复合麻醉
认知功能
心率变异性
生命体征
Hip replacement
Combined acupuncture and drug anesthesia
Cognitive function
Heart rate variability
Vital signs
