摘要
目的 探讨罗哌卡因联合舒芬太尼对髋关节置换术患者的疗效及认知功能的影响.方法 选择144 例髋关节置换术患者为研究对象.根据随机数字表法分为两组,各72 例.对照组采用罗哌卡因麻醉,观察组患者采用罗哌卡因联合舒芬太尼麻醉.比较两组患者的临床指标、简易精神状况检测量表(MMSE)评分、神经元特异性烯醇化酶(NSE)、中枢神经特异蛋白(S100β)及β-淀粉样蛋白(Aβ)水平以及不良反应发生率.结果 观察组患者的视觉模拟评分法(VAS)评分明显低于对照组(t=3.26,P＜0.05),两组患者的麻醉时间、手术时间、术中出血量及拔管时间等比较,差异均无统计学意义(t分别=0.64、0.42、0.58、0.77,P均＞0.05);术后24 h,观察组患者的NSE、S100β和Aβ水平均明显低于对照组(t分别=3.95、4.09、5.43,P均＜0.05),两组患者的MMSE评分和总不良反应发生率比较,差异均无统计学意义(t=0.33,χ2=0.36,P均＞0.05).结论 罗哌卡因联合舒芬太尼对减轻髋关节置换术患者术后疼痛有明显效果,且不明显影响患者的认知功能.
Abstract
Objective To explore the impact of ropivacaine combined with sufentanil on therapeutic efficacy and cog-nitive function in patients undergoing hip arthroplasty.Methods A total and cognitive function of 144 patients undergo-ing hip replacement surgery were selected as the study subjects,and divided into two groups according to the random number table method,with 72 cases in each group.The control group received ropivacaine anesthesia,while the observa-tion group received ropivacaine combined with sufentanil anesthesia.The clinical indexes,the score of mini mental state examination(MMSE),the level of neuron-specific enolase(NSE),central nervous system-specific proteins(S100β)and amyloid-β protein(Aβ)and the incidence of adverse reactions were compared between the two groups.Results The visual analogue scale(VAS)score of the observation group was significantly lower than that of the control group(t=3.26,P＜0.05).There was no statistically significant difference in anesthesia time,surgical time,intraoperative bleeding,and extubation time between the two groups(t=0.64,0.42,0.58,0.77,P＞0.05).At 24h after operation,the levels of NSE,S100β and Aβ in observation group were significantly lower than those in control group(t=3.95,4.09,5.43,P＜0.05),and there was no statistically significant difference in the MMSE scores and total incidence of adverse reactions between the two groups(t=0.33,χ2=0.36,P＞0.05).Conclusion Ropivacaine combined with sufentanil has a significant effect on postoperation pain in patients undergoing hip replacement surgery,and does not significantly affect their cogni-tive function.
维普
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