摘要
目的探究纳布啡复合地佐辛麻醉对髋关节置换术患者认知功能、血液流变学及神经递质的影响。方法选取2020年1月至2023年1月在九江市柴桑区中医医院行髋关节置换术的82例患者作为研究对象,采用随机数表法分为对照组和观察组各41例。对照组患者予以地佐辛麻醉,观察组患者予以纳布啡复合地佐辛麻醉。比较两组患者手术前后的疼痛程度、认知功能、血液流变学及神经递质水平。结果两组患者术后24 h及48 h的视觉模拟量表(VAS)评分较术前均显著升高,但术后48 h较术后24 h明显降低,且观察组患者术后24 h及48 h的VAS评分分别为(2.07±0.65)分、(1.76±0.58)分,明显低于对照组的(2.78±0.65)分、(2.10±0.54)分,差异均有统计学意义(P<0.05);两组患者术后24 h及48 h的简易精神状态检查量表(MMSE)评分较术前均显著降低,但术后48 h较术后24 h明显升高,且观察组患者术后24 h及48 h的MMSE评分分别为(23.71±2.3)分、(24.88±2.32)分,明显高于对照组的(22.39±1.92)分、(23.61±1.88)分,差异均有统计学意义(P<0.05);两组患者术后纤维蛋白原(FIB)、血浆黏度(PV)、红细胞聚集指数(AI)、红细胞压积(HCT)、中枢神经特异蛋白(S100β)、5-羟色胺(5-HT)、β-内啡肽(β-EP)水平较术前均显著升高,但观察组患者术后的FIB、PV、AI、HCT、S100β、5-HT、β-EP水平分别为(4.14±0.94)g/L、(1.80±0.33)m Pa/s、22.46±5.15、(48.60±5.67)%、(138.62±10.76)pg/mL、(23.99±2.57)μmol/L、(0.57±0.11)pg/mL,明显低于对照组的(4.59±1.01)g/L、(1.98±0.38)mPa/s、24.93±4.30、(51.26±5.55)%、(159.80±15.51)pg/mL、(33.62±6.26)μmol/L、(0.73±0.19)pg/mL,差异均有统计学意义(P<0.05)。结论纳布啡复合地佐辛麻醉可减轻髋关节置换术患者的疼痛感及认知功能障碍,且对血液流变学及神经递质的影响较轻。
Objective To investigate the influence of nalbuphine combined with dezocine anesthesia on cogni-tive function,hemorheology,and neurotransmitter in patients with hip replacement.Methods Eighty-two patients who underwent hip replacement in Jiujiang Chaisang District Hospital of Traditional Chinese Medicine from Jan.2020 to Jan.2023 were selected as the study objects.They were divided into a control group and an observation group by random number table method,with 41 patients in each group.The patients in the control group were given dezocine for anesthe-sia,and the patients in the observation group were given nalbuphine combined with dezocine for anesthesia.The pain de-gree,cognitive function,hemorheology,and neurotransmitter level before and after surgery were compared between the two groups.Results The Visual Analogue Scale(VAS)scores of the two groups at 24 h and 48 h after operation were significantly higher than those before operation,but the VAS scores at 48 h after operation were significantly lower than those at 24 h after operation(P<0.05).The VAS score at 24 h and 48 h after surgery in the observation group were(2.07±0.65)points,(1.76±0.58)points,respectively,which were significantly lower than(2.78±0.65)points,(2.10±0.54)points in the control group(P<0.05).The Mini-mental State Examination(MMSE)scores of the two groups at 24 h and 48 h af-ter operation were significantly lower than those before operation,but the scores at 48 h after operation were signifi-cantly higher than those at 24 h after operation(P<0.05).The MMSE score at 24 h and 48 h after surgery in the obser-vation group were(23.71±2.3)points,(24.88±2.32)points,respectively,which were significantly higher than(22.39±1.92)points,(23.61±1.88)points in the control group(P<0.05).The fibrinogen(FIB),plasma viscosity(PV),red blood cell aggregation index(AI),hematokrit(HCT),central nerve specific protein(S100β),5-hydroxytryptamine(5-HT)andβ-endorphin(β-EP)after surgery of two groups were significantly higher than those before operation,with statisti-cally significant differences(P<0.05).The FIB,PV,AI,HCT,S100β,5-HT,andβ-EP levels after surgery in the obser-vation group were(4.14±0.94)g/L,(1.80±0.33)mPa/s,22.46±5.15,(48.60±5.67)%,(138.62±10.76)pg/mL,(23.99±2.57)μmol/L,(0.57±0.11)pg/mL,respectively,which were significantly lower than(4.59±1.01)g/L,(1.98±0.38)mPa/s,24.93±4.30,(51.26±5.55)%,(159.80±15.51)pg/mL,(33.62±6.26)μmol/L,(0.73±0.19)pg/mL in the control group(P<0.05).Conclusion Nalbuphine combined with dezocine can reduce the pain and cognitive function dysfunction of pa-tients with hip replacement,and had less effect on hemorheology and neurotransmitter.
作者
吴有泉
王明
WU You-quan;WANG Ming(Department of Anesthesiology,Jiujiang Chaisang District Hospital of Traditional Chinese Medicine,Jiujiang 332100,Jiangxi,CHINA)
出处
《海南医学》
CAS
2024年第1期57-61,共5页
Hainan Medical Journal
