依达拉奉对老年患者髋关节置换术术后谵妄的影响

发布时间：2019-06-14 23:01

【摘要】：目的术后谵妄(postoperative delirium,POD)是老年患者术后常见的中枢神经系统并发症,文中评价依达拉奉对髋关节置换术老年患者术后谵妄的作用。方法 2012年6月至2014年3月间在南京军区南京总医院蛛网膜下腔麻醉下行单侧髋关节置换术的老年患者246例,随机数字表法分为依达拉奉组和对照组。依达拉奉组于麻醉诱导前静脉给予依达拉奉30 mg,对照组给予等量等渗盐水。术前1 d及术后1 d采用意识混乱评估法对患者进行评估,记录患者一般临床资料并观察患者住院时间、术后急性肺栓塞、心肌梗死、脑梗死及POD发生率;于术前1 d及术后1 d测定血浆丙二醛(malondialdehyde,MDA)、超氧化物歧化酶(superoxide dismutase,SOD)、神经原特异性烯醇化酶(neuron-specific enolase,NSE)及S100β蛋白(S100β)表达水平。结果 2组患者住院时间与围术期急性肺栓塞、心肌梗死及脑梗死发生率比较结果差异无统计学意义(P0.05);依达拉奉组POD发生率明显低于对照组(17.7%vs 30.3%,P0.05)。2组患者术前血浆MDA、SOD、NSE及S100β比较差异无统计学意义(P0.05)。依达拉奉组术后1 d血浆MDA及NSE均明显低于对照组,分别为[(2.2±0.5)nmol/L vs(3.6±0.7)nmol/L,P0.05]和[(6.3±2.2)μg/L vs(8.6±2.8)μg/L,P0.05]。结论依达拉奉可降低髋关节置换术老年患者POD的发生率,在临床应用中具有促进神经功能康复的作用。
[Abstract]:Objective postoperative delirium (postoperative delirium,POD) is a common central nervous system complications in elderly patients. The effect of Edaravone on postoperative delirium in elderly patients undergoing hip arthroplasty is evaluated in this paper. Methods 246 elderly patients undergoing unilateral hip arthroplasty under subarachnoid anesthesia in Nanjing General Hospital of Nanjing military region from June 2012 to March 2014 were randomly divided into Edaravone group and control group. Edaravone group was treated with Edaravone 30 mg, control group before anesthesia induction. The patients were evaluated by the method of confusion of consciousness 1 day before operation and 1 day after operation. The general clinical data of the patients were recorded and the hospitalization time, the incidence of acute pulmonary embolism, myocardial infarction, cerebral infarction and POD were observed. The levels of plasma malondialdehyde (malondialdehyde,MDA), superoxide dismutase (superoxide dismutase,SOD), neurogen-specific enolase (neuron-specific enolase,NSE) and S100 尾 protein (S100 尾) were measured 1 day before operation and 1 day after operation. Results there was no significant difference in the incidence of acute pulmonary embolism, myocardial infarction and cerebral infarction between the two groups (P 0.05), but the incidence of POD in the Edaravone group was significantly lower than that in the control group (17.7%vs 30.3%, P 0.05). There was no significant difference in plasma MDA,SOD,NSE and S100 尾 between the two groups (P 0.05). The plasma MDA and NSE in the Edaravone group were significantly lower than those in the control group on the 1st day after operation, which were [(2.2 卤0.5) nmol/L vs (3.6 卤0.7) nmol/L,P0.05] and [(6.3 卤2.2) 渭 g / L vs (8.6 卤2.8) 渭 g / L, respectively, P 0.05]. Conclusion Edaravone can reduce the incidence of POD in elderly patients undergoing hip arthroplasty and can promote the rehabilitation of neurological function in clinical application.
【作者单位】：南京军区南京总医院麻醉科;
【基金】：南京军区南京总医院科研基金(2011035)
【分类号】：R614

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