解放军医学院学报
解放軍醫學院學報
해방군의학원학보
Academic Journal of Chinese Pla Medical School
2015年
5期
473-476
,共4页
谭宇桔%徐志鹏%姜雨鸽%张宏
譚宇桔%徐誌鵬%薑雨鴿%張宏
담우길%서지붕%강우합%장굉
依达拉奉%老年人%膝关节置换术%术后认知功能障碍
依達拉奉%老年人%膝關節置換術%術後認知功能障礙
의체랍봉%노년인%슬관절치환술%술후인지공능장애
edaravone%aged%knee arthroplasty%postoperative cognitive dysfunction
目的：观察氧自由基清除剂依达拉奉预处理对老年患者膝关节置换术后认知功能的影响。方法选择2014年5-9月在我院择期全麻下行全膝关节置换术的老年患者90例，年龄60~79岁，ASAⅠ~Ⅱ级，术前简易精神状态检查表(mini-mental state examination，MMSE)评分≥23分，随机分为2组，依达拉奉组(E组)和对照组(C组)，每组45例，分别于麻醉诱导前30 min给予依达拉奉0.5 mg/kg(E组)和等量的氯化钠注射液(C组)。于术前1 d(T0)、术后第1天(T1)、术后第5天(T2)采用国际术后认知功能障碍研究协作组(international study of postoperative cognitive dysfunction，ISPOCD)推荐的量表对患者的认知功能进行评估。结果 T0时两组神经心理学评估量表评分无统计学差异(P＞0.05)。两组术后认知功能障碍(postoperative cognitive dysfunction，POCD)发生率在T1时E组11.11%、C组33.33%；在T2时E组6.67%、C组22.22%， T1、T2时，E组POCD的发生率均低于C组(P=0.01，P=0.04)。结论依达拉奉预处理可以降低老年患者膝关节置换术POCD的发生率，改善老年患者的术后认知功能。
目的：觀察氧自由基清除劑依達拉奉預處理對老年患者膝關節置換術後認知功能的影響。方法選擇2014年5-9月在我院擇期全痳下行全膝關節置換術的老年患者90例，年齡60~79歲，ASAⅠ~Ⅱ級，術前簡易精神狀態檢查錶(mini-mental state examination，MMSE)評分≥23分，隨機分為2組，依達拉奉組(E組)和對照組(C組)，每組45例，分彆于痳醉誘導前30 min給予依達拉奉0.5 mg/kg(E組)和等量的氯化鈉註射液(C組)。于術前1 d(T0)、術後第1天(T1)、術後第5天(T2)採用國際術後認知功能障礙研究協作組(international study of postoperative cognitive dysfunction，ISPOCD)推薦的量錶對患者的認知功能進行評估。結果 T0時兩組神經心理學評估量錶評分無統計學差異(P＞0.05)。兩組術後認知功能障礙(postoperative cognitive dysfunction，POCD)髮生率在T1時E組11.11%、C組33.33%；在T2時E組6.67%、C組22.22%， T1、T2時，E組POCD的髮生率均低于C組(P=0.01，P=0.04)。結論依達拉奉預處理可以降低老年患者膝關節置換術POCD的髮生率，改善老年患者的術後認知功能。
목적：관찰양자유기청제제의체랍봉예처리대노년환자슬관절치환술후인지공능적영향。방법선택2014년5-9월재아원택기전마하행전슬관절치환술적노년환자90례，년령60~79세，ASAⅠ~Ⅱ급，술전간역정신상태검사표(mini-mental state examination，MMSE)평분≥23분，수궤분위2조，의체랍봉조(E조)화대조조(C조)，매조45례，분별우마취유도전30 min급여의체랍봉0.5 mg/kg(E조)화등량적록화납주사액(C조)。우술전1 d(T0)、술후제1천(T1)、술후제5천(T2)채용국제술후인지공능장애연구협작조(international study of postoperative cognitive dysfunction，ISPOCD)추천적량표대환자적인지공능진행평고。결과 T0시량조신경심이학평고량표평분무통계학차이(P＞0.05)。량조술후인지공능장애(postoperative cognitive dysfunction，POCD)발생솔재T1시E조11.11%、C조33.33%；재T2시E조6.67%、C조22.22%， T1、T2시，E조POCD적발생솔균저우C조(P=0.01，P=0.04)。결론의체랍봉예처리가이강저노년환자슬관절치환술POCD적발생솔，개선노년환자적술후인지공능。
Objective To investigate the influence of edaravone on postoperative cognitive function in elderly patients undergoing knee replacement surgery.Methods Ninety ASAⅠ-Ⅱ elderly patients aged from 65 to 79 years old with MMSE score≥ 23 who underwent knee arthroplasty surgery in our hospital from May to September in 2014 were randomly divided into edaravone group (group E, n=45) and control group (group C, n=45). Patients in group E were given edaravone accounting for 0.5 mg/kg while the same amount of sodium chloride injection in group C was given 30 min before anesthesia induction. The cognitive function of the patients was assessed preoperative, on the 1st and 5th postoperative day with the scale recommended by the international study of postoperative cognitive dysfunction. Results On the 1st postoperative day, the incidence of postoperative cognitive dysfunction were 11.11% and 33.33% in group E and group C; On the 5th postoperative day, the corresponding data was 6.67% and 22.22%, respectively. On the 1st and 5th postoperative day, the incidence of POCD in group E was lower than that of group C (P=0.01,P=0.04).ConclusionThe data indicate that edaravone pretreatment can reduce the occurrence of POCD in elderly patients undergoing knee arthroplasty, improve the postoperative cognitive function of senile patients.
