摘要
目的分析骨科老年手术患者麻醉需求,评价七氟烷吸入麻醉对老年患者认知功能、炎性反应等方面的影响。方法94例老年骨折患者,随机分为观察组与对照组,各47例。对照组采取常规静脉麻醉,观察组采取七氟烷吸入麻醉。比较两组手术前后的认知功能及炎性反应情况。结果术后当天、术后1周观察组的参考蒙特利尔认知量表(MoCA)评分分别为(24.20±1.05)、(27.50±1.50)分,均高于对照组的(20.28±1.03)、(25.20±1.30)分,差异有统计学意义(P<0.05)。术后当天、术后1周,观察者组白细胞介素-6(IL-6)分别为(99.90±8.80)、(49.50±5.50)μg/ml,肿瘤坏死因子α(TNF-α)分别为(81.75±8.50)、(45.55±4.50)μg/ml,均低于对照组的(118.20±9.03)μg/ml、(55.80±6.60)μg/ml、(102.80±10.03)pg/ml、(50.80±5.50)pg/ml,差异有统计学意义(P<0.05)。结论老年骨折手术患者术后认知功能障碍风险较高,对麻醉工作提出了更高的要求。七氟烷吸入麻醉可以减轻老年患者术后患者炎性反应、认知功能损伤,麻醉效果显著。
Objective To analyze the anesthesia needs of elderly patients after orthopedic surgery,and to evaluate the effects of sevoflurane inhalation anesthesia on cognitive function and inflammatory response in elderly patients.Methods 94 elderly patients with fracture were randomly divided into an observation group and a control group,with 47 patients in each group.The control group was treated with conventional intravenous anesthesia,and the observation group was treated with sevoflurane inhalation anesthesia.The cognitive function and the inflammatory response after surgery were compared between these two groups.Results The Montreal Cognitive Assessment(MoCA)scores of the observation group on the surgery day and 1 week after surgery were(24.20±1.05),(27.50±1.50),respectively,which were higher than(20.28±1.03),(25.20±1.30)of the control group,and the difference was statistically significant(P<0.05).On the surgery day and 1 week after surgery,the observation group had interleukin-6(IL-6)of(99.90±8.80)μg/ml,(49.50±5.50)μg/ml,respectively,and tumor necrosis factor-α(TNF-α)of(81.75±8.50)μg/ml,(45.55±4.50)μg/ml,respectively,which were lower than corresponding(118.20±9.03)μg/ml,(55.80±6.60)μg/ml,(102.80±10.03)pg/ml,(50.80±5.50)pg/ml of the control group,and the difference was statistically significant(P<0.05).Conclusion Elderly patients after fracture surgery have higher risk of postoperative cognitive dysfunction,thus requiring higher requirements for anesthesia.Sevoflurane inhalation anesthesia can reduce the inflammatory response and cognitive impairment in elderly patients,and has a significant anesthetic effect.
作者
王雅杰
WANG Ya-jie(Department of Anesthesiology,Dandong Central Hospital,Dandong 118002,China)
出处
《中国现代药物应用》
2021年第18期144-146,共3页
Chinese Journal of Modern Drug Application
关键词
静脉麻醉
七氟烷
骨科手术
老年患者
认知功能
Intravenous anesthesia
Sevoflurane
Orthopedic surgery
Elderly patients,Cognitive function
