摘要
目的研究术前镇痛对老年下肢骨折患者围术期应激反应和术后认知功能的影响方法选取2017年10月-2018年8月骨科收治的下肢骨折需行切开复位内固定术的老年患者106例,年龄≥65岁,随机分为实验组(E组)54例和对照组(C组)52例.E组患者入院评估后进行静脉自控镇痛(PCIA),C组患者入院评估后不进行PCIA,在各时间点测定2组患者生理指标、疼痛评分、血清应激指标以及认知功能,比较2组患者不同时间点各指标的差异性。结果E组患者应激指标在镇痛后12h、24h及术后2d、4d均低于C组(P<0.05);E组认知功能评分在术后2d、4d、7d均高于C组,差异有统计学意义(P<0.05).结论术前镇痛能有效减轻老年下肢骨折患者围术期疼痛刺激及应激反应,减少术后早期认知功能障碍发生。
Objective To investigate the effects of preemptive analgesia on peri - operative stress reaction and postoperative cognitive function in elderly patients with lower limb fracture. Methods A total of 106 elderly patients aged 65 years or above with lower extremity fractures who need open reduction internal fixation (ORIF) from October 2017 to August 2018 were selected and were randomly divided into an observation group ( group E) and a control group ( group C), with 54 patients in group E and 52 patients in group C. Patients in group E received patient - controlled intravenous analgesia (PCIA) after admission assessment, while patients in group C did not receive PCIA after admission assessment. The physiological in dices, visual analogue scale ( VAS), serologic reactions, and cognitive functio n (mini - mental state examination, MMSE) during different time periods were observed and compared between the two groups. Results The stress reaction indices in Group E at 12 h and 24 h after preemptive analgesia and 2 d and 4 d after operation were significantly lower than those in group C ( P < 0. 05 ). The MMSE scores in group E at 2 , 4 , and 7 d after the operation were significantly higher than those in group C (P <0. 05). Conclusions The preemptive an algesia can relieve the degree of stress reaction during the operation in elderly patients with lower limb fracture and reduce the possibility of postoperative cognitive dysfunction ( POCD).
作者
耿川
王光磊
GENG Chuan;WANG Guanglei(Sohool of Anesthesiology, Xuzhou Medical University, Xuzhou, Jiangsu 221004 , China;Department of Anesthesiology, Fengxian People's Hospital, Fengxian County, Jiangsu 221700;Department of Anesthesiology, the Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221002)
出处
《徐州医科大学学报》
CAS
2019年第5期354-358,共5页
Journal of Xuzhou Medical University
关键词
术前镇痛
老年骨折患者
应激反应
认知功能
preemptive analgesia
elderly patients with lower limb fracture
stress reaction
cognitive function
