摘要
目的:探讨七氟烷复合瑞芬太尼麻醉在老年股骨颈骨折(FNF)患者术中发挥脑保护作用的效果。方法:选取2023年1月—2024年8月潍坊市中医院收治的100例老年FNF患者为研究对象,按随机数字表法将其分为对照组及研究组,各50例。对照组行丙泊酚复合瑞芬太尼麻醉,研究组行七氟烷复合瑞芬太尼麻醉。比较两组血流动力学指标、脑代谢指标、麻醉恢复情况、认知功能、疼痛程度及不良反应发生情况。结果:手术开始30 min、缝合切口时,研究组的心率、舒张压、收缩压均高于对照组,差异均有统计学意义(P<0.05)。手术开始30 min、缝合切口时,研究组的脑氧摄取率、静脉血氧饱和度、脑灌注压均高于对照组,差异均有统计学意义(P<0.05)。研究组的自主呼吸恢复、睁眼及定向力恢复时间均短于对照组,差异均有统计学意义(P<0.05)。术后24 h研究组的简易智能精神状态检查量表评分高于对照组,术后6、24 h的疼痛视觉模拟法评分均低于对照组,差异均有统计学意义(P<0.05)。研究组的不良反应发生率为8.00%,与对照组的16.00%比较,差异无统计学意义(P>0.05)。结论:将七氟烷复合瑞芬太尼麻醉应用于老年FNF患者术中,具有良好的脑保护作用,可减轻脑代谢指标异常状态,避免术后认知功能减退,且能稳定术中血流动力学,安全可靠。
Objective:To explore the application effect of Sevoflurane combined with Remifentanil anesthesia playing a role in protecting the brain during the operation in elderly patients with femoral neck fractures(FNF).Methods:A total of 100 elderly patients with FNF admitted to Weifang Traditional Chinese Medicine Hospital from January 2023 to August 2024 were selected as the research subjects and were divided into a control group and a study group according to the random number table method,with 50 cases in each group.The control group received anesthesia with Propofol combined with Remifentanil,while the study group received anesthesia with Sevoflurane combined with Remifentanil.The hemodynamic indicators,brain metabolic indicators,anesthesia recovery,cognitive function,pain degree and the occurrence of adverse reactions of the two groups were compared.Results:At 30 minutes after the start of the surgery and when the incision was sutured,the heart rates,diastolic blood pressures and systolic blood pressures of the study group were higher than those of the control group,the differences were statistically significant(P<0.05).At 30 minutes after the start of the surgery and when the incision was sutured,the cerebral oxygen uptake rates,venous oxygen saturations and cerebral perfusion pressures in the study group were higher than those in the control group,the differences were statistically significant(P<0.05).The recovery times of spontaneous breathing,eye opening and orientation in the study group were shorter than those in the control group,the differences were statistically significant(P<0.05).24 hours after surgery the score of the Mini-Mental State Examination of the study group was higher than that of the control group,6 hours and 24 hours after the scores of the Pain Visual Analogue Scale were lower than those of the control group,the differences were statistically significant(P<0.05).The incidence of adverse reactions in the study group was 8.00%,compared with 16.00%in the control group,the difference was not statistically significant(P>0.05).Conclusion:The application of sevoflurane combined with remifentanil anesthesia in elderly patients with FNF during surgery has a good brain protective effect.It can alleviate the abnormal state of brain metabolic indicators,avoid postoperative cognitive decline,and stabilize intraoperative hemodynamics.It is safe and reliable.
作者
李伟
LI Wei(Department of Anesthesiology,East Campus of Weifang Traditional Chinese Medicine Hospital,Weifang 261000,China)
出处
《中国伤残医学》
2025年第9期74-78,共5页
Chinese Journal of Trauma and Disability Medicine
关键词
股骨颈骨折
七氟烷
瑞芬太尼
脑保护
Femoral neck fracture
Sevoflurane
Remifentanil
Brain protection
