摘要
目的观察帕瑞昔布钠超前镇痛对老年人全身麻醉下腹腔镜胆囊切除术后认知功能及炎性因子的影响。方法选择在全身麻醉下行腹腔镜胆囊切除术（LC）患者60例，采用随机数字表法随机分为帕瑞昔布钠组（P组）和对照组（C组）。P组于麻醉诱导前30min静脉注射帕瑞昔布钠40nag，C组静脉注射0．9％氯化钠注射液5mL。于术前1h（T0）、术后2h（T1）、术后24h（T2）及术后48h（L）各时点采用简易智力状态检查表（MMSE）评分，抽取静脉血采用酶联免疫吸附法（ELISA）测量血清白细胞介素（IL）-1B、IL-6、肿瘤坏死因子-α（TNF-α）浓度。结果P组在T】及T2的MMSE评分（25．4±0．6）、（27．2±0．1）分及血清IL-1β、IL-6和TNF-α浓度[T1时的血清IL—1β、IL-6和TNF-α浓度分别为（18．43±4．45）pg／mL、（165．34±9．57）pg／mL、（34．43±3．83）pg／mL；T2时分别为（14．59±2．59）pg／mL、（98．99±7．28）pg／mL、（22．32±3．81）pg／mL]均高于C组[T1时的血清IL-1β、IL-6和TNF-α浓度分别为（23．97±3．85）pg／mL、（204．19±12．44）pg／mL、（37．77±4．81）pg／mL；T2时分别为（19．33±3．18）pg／mL、（121．35±9．67）pg／mL、（29．01±3．39）pg／mL，而在L差异则无统计学意义；P组血清IL-1β、IL-6和TNF-α浓度在T，及T2明显低于T0[（9．57±2．24）pg／mL、（46．15±6．18）pg／mL、（14．48±3．14）pg／mL，而在T3差异则无统计学意义。结论帕瑞昔布钠可以抑制炎性反应，降低老年患者全身麻醉术后早期认知功能障碍的发生。
Objective To study the effect of parecoxib sodium preemptive analgesia on the postoperative cognition and inflammatory cytokines in elderly patients. Methods Sixty elderly male patients undergoing replace- ment of total hip were randomly divided into two groups：the control group （group C,30 eases） and the parecoxib sodi- um group（group P,30 cases）. In group C, physiological saline 5 ml was injected after induction of anesthesia. Pare- eoxib sodium 40 nag was injected after induction of anesthesia in group P. Peripheral venous blood was collected at the following time points ：2h before operation （ TO ） , and 4h （ T1 ）, 24h （ T2 ） and 48h （ T3 ） after operation. And the serum concentrations of IL - 1β, IL - 6, tumor necrosis factor ct （ TNF - α） were measured by enzyme linked immunosorbent assay （ELISA）. Cognitive function was assessed by mini - mental state examination （ MMSE ） at the time of T0 - T3. Results The MMSE scores in group P [ （ 25.4 ± 0.6 ） points, （27.2 ±0. 1 ） points ] were significandy higher than those in group C at T1 and T2. Tne concentrations of IL - 1β,IL -6 and TNF -α in group PIT1 ：（18.43 ±4.45）pg/mL, （ 165.34 ±9.57） pg/mL, （34.43 ± 3.83 ） pg/mL; T2 ： （ 14.59 ±2.59 ） pg/mL, （ 98.99 ± 7.28 ） pg/mL, （ 22.32±3.81 ） pg/mL ] were lower than those in group C [ T1 ： （ 23.97 ± 3.85 ） pg/mL, （ 204.19 ± 12.44 ） pg/mL, （ 37.77 ±4. 81 ） pg/mL; T2 ： （ 19.33 ±3.18） pg/mL, （ 121.35 ± 9.67 ） pg/mL, （ 29.01 ± 3.39 ） pg/mL ] at T1, T2. The concen- trations of IL - 1β, IL - 6 and TNF -α and the MMSE scores had no differences in group P and group C at T3. The concentrations of IL - 1β, IL - 6 and TNF - α in group P at T1 and T2 [ （9.57 ± 2.24） pg/mL, （46.15 ±6. 18 ） pg/mL, （14.48 ± 3.14 ）pg/mL] were lower than those at TO, and had no difference at Ta. Conclusion Parecoxib sodium preemptive can reduce the incidence of POCD in elderly patients by inhibiting the release of early postoperative pro - inflammatory cytokines.
出处
《中国基层医药》
CAS
2016年第5期683-686,共4页
Chinese Journal of Primary Medicine and Pharmacy
基金
基金项目：陕西省榆林市科技计划项目（2014jh-20）
关键词
麻醉
术后认知功能障碍
炎性因子类
老年人
帕瑞昔布钠
Anesthesia
Postoperative cognitive dysfunction
Inflammatory cytokines
Elder
Parecoxibsodium
