| 杜克信,邱正国,郑仲磊,秦 艳,王 燕.七氟烷复合麻醉对老年骨科患者术后早期认知功能的影响[J].,2020,(22):4352-4355 |
| 七氟烷复合麻醉对老年骨科患者术后早期认知功能的影响 |
| Effects of Sevoflurane Anesthesia on Early Cognitive Function in Elderly Patients with Orthopedics |
| 投稿时间：2020-02-28 修订日期：2020-03-23 |
| DOI：10.13241/j.cnki.pmb.2020.22.034 |
| 中文关键词: 七氟烷 麻醉 全膝关节置换手术 认知功能 老年人 |
| 英文关键词: Sevoflurane Anesthesia Total knee arthroplasty Cognitive function Elderly |
| 基金项目:国家自然科学基金项目（81273902）；陕西省社会发展科技攻关项目（2016SF-166） |
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| 中文摘要: |
| 摘要 目的：探讨七氟烷复合麻醉对老年骨科患者术后早期认知功能的影响。方法：选择2017年12月~2019年6月在西安医学院第二附属医院（本院）骨科诊治单侧老年全膝关节置换手术患者112例，随机数字表法分为七氟烷组与对照组，各56例。对照组给予常规静脉注射全身麻醉，在此基础上七氟烷组给予七氟烷吸入麻醉，记录与调查两组术后早期认知功能。结果：经过对比，两组手术时间、术中出血量对比差异无统计学意义(P>0.05)，而七氟烷组的术后苏醒时间(7.10±0.22)min、拔管时间(8.65±0.46)min等都显著短于对照组(14.09±1.09)min、(18.76±1.44)min，两组对比有统计学意义(P<0.05)。所有患者在T1、T2、T3与T4时间点的心率和血氧饱和度均表现正常，对比均无统计学意义(P>0.05)。七氟烷组术后1 d、术后14 d的血清白介素(Interleukin，IL)-6、肿瘤坏死因子(Tumor necrosis factor，TNF)-α值显著低于对照组，对比有统计学意义(P<0.05)，且两组术后14 d的血清IL-6与TNF-α值均显著低于术后1 d (P<0.05)。术后1个月七氟烷组的认知功能障碍发生率为1.8 %（1/56），显著低于对照组的12.5 %（7/56），两组间对比有统计学意义(x2=4.846，P=0.028)。结论：七氟烷复合麻醉在老年骨科患者中的应用能促进患者康复，安全性比较好，能抑制炎症因子的释放，从而减少术后早期认知功能障碍的发生。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the effects of sevoflurane anesthesia on early cognitive function in elderly patients with orthopedics. Methods: From December 2017 to June 2019, 112 cases of patients with unilateral elderly total knee arthroplasty were selected as patients in the orthopedics department of our hospital and were equally divided into sevoflurane group and the control group accorded to random number table. The control group were given general intravenous anesthesia, and the sevoflurane group were given sevoflurane inhalation anesthesia. The early cognitive function of the two groups were recorded and investigated. Results: There were no significant difference in the operation time and intraoperative blood loss compared between the two groups(P>0.05). The postoperative wake-up time(7.10.22) min and extubation time(8.65±0.46) min in the sevoflurane group were significantly shorter than those of the control group(14.09±1.09) min and (18.76±1.44) min. The comparison between the two groups was statistically significant (P<0.05). The heart rate and blood oxygen saturation of all patients at time points T1, T2, T3 and T4 were normal, and there were no statistically significant difference compared between the groups(P>0.05). The serum interleukin(IL) -6 and Tumor necrosis factor (TNF) -α values in the sevoflurane group were significantly lower control group at 1 and 14 days after surgery(P<0.05), and the serum IL-6 and TNF-α values of the two groups were significantly lower than that of the 1 day after the operation (P<0.05). The incidence of cognitive dysfunction in the sevoflurane group at 1 month after operation was 1.8 % (1/56), which was significantly lower than that of the control group at 12.5 % (7/56) (P<0.05), the comparison between the two groups was statistically significant (x2=4.846, P=0.028). Conclusion: The application of sevoflurane anesthesia in elderly orthopedic patients can promote the rehabilitation of patients, has better safety, can inhibit the release of inflammatory factors, and reduce the incidence of early postoperative cognitive dysfunction. |
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