实用药物与临床
實用藥物與臨床
실용약물여림상
PRACTICAL PHARMACY AND CLINICAL REMEDIES
2015年
4期
421-424
,共4页
卞慧娴%杜海亮%王娇%王俊
卞慧嫻%杜海亮%王嬌%王俊
변혜한%두해량%왕교%왕준
术后认知功能障碍%疼痛%髋关节置换%老年患者
術後認知功能障礙%疼痛%髖關節置換%老年患者
술후인지공능장애%동통%관관절치환%노년환자
Postoperative cognitive dysfunction%Pain%Hip replacement%Elderly patient
目的：探讨术前疼痛病程对术后早期认知功能的影响。方法择期全麻下行单侧全髋关节置换老年患者70例,按术前疼痛持续时间分为2组：A组(<3个月)35例,B组(≥3个月)35例。麻醉诱导均采用咪达唑仑、舒芬太尼、依托咪酯、顺式阿曲库铵静脉注射,气管插管后静吸复合维持麻醉。分别于术前1d、术后24 h、术后72 h进行VAS评分和简易智能评价量表( MMSE)评分。术后MMSE评分较术前降低2分以上,则认为发生术后认知功能障碍( POCD)。结果各时点两组患者VAS评分比较差异无统计学意义。术后24 h POCD发生率A组为21．2%,B组为48．6%,两组比较差异有统计学意义( P<0．05)。术后72 h POCD发生率A组为18．2%,B组为31．4%,两组比较差异无统计学意义( P>0．05)。结论术前存在慢性疼痛的髋关节置换患者(疼痛病程≥3个月),POCD发生率更高。
目的：探討術前疼痛病程對術後早期認知功能的影響。方法擇期全痳下行單側全髖關節置換老年患者70例,按術前疼痛持續時間分為2組：A組(<3箇月)35例,B組(≥3箇月)35例。痳醉誘導均採用咪達唑崙、舒芬太尼、依託咪酯、順式阿麯庫銨靜脈註射,氣管插管後靜吸複閤維持痳醉。分彆于術前1d、術後24 h、術後72 h進行VAS評分和簡易智能評價量錶( MMSE)評分。術後MMSE評分較術前降低2分以上,則認為髮生術後認知功能障礙( POCD)。結果各時點兩組患者VAS評分比較差異無統計學意義。術後24 h POCD髮生率A組為21．2%,B組為48．6%,兩組比較差異有統計學意義( P<0．05)。術後72 h POCD髮生率A組為18．2%,B組為31．4%,兩組比較差異無統計學意義( P>0．05)。結論術前存在慢性疼痛的髖關節置換患者(疼痛病程≥3箇月),POCD髮生率更高。
목적：탐토술전동통병정대술후조기인지공능적영향。방법택기전마하행단측전관관절치환노년환자70례,안술전동통지속시간분위2조：A조(<3개월)35례,B조(≥3개월)35례。마취유도균채용미체서륜、서분태니、의탁미지、순식아곡고안정맥주사,기관삽관후정흡복합유지마취。분별우술전1d、술후24 h、술후72 h진행VAS평분화간역지능평개량표( MMSE)평분。술후MMSE평분교술전강저2분이상,칙인위발생술후인지공능장애( POCD)。결과각시점량조환자VAS평분비교차이무통계학의의。술후24 h POCD발생솔A조위21．2%,B조위48．6%,량조비교차이유통계학의의( P<0．05)。술후72 h POCD발생솔A조위18．2%,B조위31．4%,량조비교차이무통계학의의( P>0．05)。결론술전존재만성동통적관관절치환환자(동통병정≥3개월),POCD발생솔경고。
Objective To investigate the effects of preoperative pain duration on early postoperative cognitive dysfunction (POCD). Methods According to the duration of preoperative pain,70 elderly patients underwent elective unilateral total hip replacement were divided into two groups,group A (preoperative pain duration<3 months,n=35) and group B(preoperative pain duration≥3 months,n=35). All cases were induced by midazolam,sufentanil,etomid-ate,cisatracurium, and maintained with inhalation-intravenous balanced anesthesia after endotracheal intubation. The clinical effects were assessed by VAS and MMSE scores. The scores were recorded at 1 d before operation and 24 h,72 h after operation. POCD was considered to occur as postoperative MMSE score decreased 2 or more points. Results The VAS scores of the two groups at every time point had no significant difference. The incidence of POCD at 24 h af-ter operation in group A was lower than that in group B (21. 2% vs. 48. 6%,P<0. 05). The incidences of POCD at 72 h after operation in group A and group B were 18. 2% and 31. 4%,there was no significant difference between the two groups ( P>0. 05 ) . Conclusion Chronic pain patients ( preoperative pain duration≥3 months ) have higher POCD rates after total hip replacement operation.
