| 曾强龙,乔 伟,李 雷,李 伟,王晓飞,毕正宾.瑞芬太尼联合七氟烷对老年全髋关节置换术患者苏醒质量、应激反应和血清NSE、S-100β蛋白的影响[J].,2023,(15):2970-2973 |
| 瑞芬太尼联合七氟烷对老年全髋关节置换术患者苏醒质量、应激反应和血清NSE、S-100β蛋白的影响 |
| Effects of Remifentanil Combined with Sevoflurane on Awakening Quality, Stress Response and Serum NSE and S-100β Protein in Elderly Patients with Total Hip Arthroplasty |
| 投稿时间：2023-02-27 修订日期：2023-03-23 |
| DOI：10.13241/j.cnki.pmb.2023.15.033 |
| 中文关键词: 瑞芬太尼 七氟烷 老年 全髋关节置换术 苏醒质量 应激反应 神经元特异性烯醇化酶 S-100β蛋白 |
| 英文关键词: Remifentanil Sevoflurane Elderly Total hip arthroplasty Awakening quality Stress response Neuron specific enolase S-100β protein |
| 基金项目:安徽省自然科学基金项目（1408085MH207） |
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| 摘要 目的：探讨瑞芬太尼联合七氟烷对老年全髋关节置换术（THA）患者苏醒质量、应激反应和血清神经元特异性烯醇化酶（NSE）、S-100β蛋白的影响。方法：选择2020年4月~2022年5月期间蚌埠医学院第三附属医院收治的85例老年THA患者，按照随机数字表法将患者分为观察组（七氟烷、瑞芬太尼复合麻醉，n=43）和对照组（瑞芬太尼麻醉，n=42）。观察并比较两组苏醒质量、镇静、镇痛情况、应激反应指标和血清NSE、S-100β蛋白水平、术后认知功能障碍（POCD）发生率以及围术期不良反应发生率。结果：与对照组相比，观察组的意识消失时间、拔管时间、苏醒时间更短（P<0.05）。观察组术后12 h肾上腺素（E）、去甲肾上腺素（NE）、皮质醇（Cor）均低于对照组同时间点（P<0.05）。观察组术后12 h视觉疼痛模拟评分（VAS）低于对照组同时间点；Ramsay镇静评分高于对照组同时间点（P<0.05）。观察组术后12 h NSE、S-100β蛋白低于对照组同时间点（P<0.05）。观察组的POCD发生率低于对照组（P<0.05）。两组不良反应发生率组间对比无统计学差异（P>0.05）。结论：瑞芬太尼联合七氟烷应用于老年THA患者，镇静、镇痛效果较好，可提高苏醒质量，减轻应激反应程度，降低POCD发生率，调节血清NSE、S-100β蛋白水平。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effects of remifentanil combined with sevoflurane on awakening quality, stress response, serum neuron specific enolase (NSE) and S-100β protein in elderly patients with total hip arthroplasty (THA). Methods: 85 elderly patients with THA who were admitted to the Third Affiliated Hospital of Bengbu Medical College from April 2020 to May 2022 were selected, and they were divided into observation group (sevoflurane and remifentanil combined anesthesia, n=43) and control group (remifentanil anesthesia, n=42) according to random number table method. The awakening quality, sedation, analgesia, stress response indexes, serum NSE and S-100β protein levels, postoperative cognitive dysfunction (POCD) and perioperative adverse reactions were observed and compared between the two groups. Results: Compared with the control group, the observation group had shorter periods of consciousness disappearance, extubation, and awakening (P<0.05). Epinephrine (E), norepinephrine (NE) and cortisol (Cor) in the observation group at postoperative 12 h were lower than those in the control group at the same time point (P<0.05). Visual pain simulation scores (VAS) in the observation group at postoperative 12 h were lower than those in the control group at the same time point (P<0.05). Ramsay sedation score was higher than that in the control group at the same time point (P<0.05). The NSE and S-100β protein in the observation group at postoperative 12 h were lower than those in the control group at the same time point (P<0.05). The incidence of POCD in the observation group was lower than that in the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion: Remifentanil combined with sevoflurane has better sedative and analgesic effect in elderly patients with THA, which can improve the awakening quality, reduce the degree of stress response, reduce the incidence of POCD, regulate the serum NSE and S-100β protein levels. |
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