CAJ | 학술논문

目的：探讨地佐辛预注对高龄行全髋置换患者术后认知功能及血清S100-β蛋白水平的影响。方法选择择期全身麻醉全髋关节手术的患者60例。随机分为地佐辛组和安慰剂组，每组30例，地佐辛组：手术结束前30 min静脉注射地佐辛0.08 mg/kg，安慰剂组：手术结束前30 min静脉注射同等量的0.9%氯化钠注射液。记录并比较两组拔管时间、苏醒时间、视觉模拟疼痛评分（VAS）、血清S100-β蛋白。结果地佐辛组拔管时间和苏醒时间较安慰剂组长（t分别=3.88、3.48，P均＜0.05），拔管后各时间点VAS评分均比安慰剂组低（t分别=10.60、7.75、9.60、9.31、9.37， P均＜0.05）。术后6 h、1 d 地佐辛组MMSE评分明显高于安慰剂组（t分别=2.04、2.28，P均＜0.05）。两组认知功能障碍（POCD）的发生率比较，差异有统计学意义（χ2=2.68，P＜0.05）。安慰剂组术后24 h血清S100-β蛋白浓度较术前1 d明显升高且高于同时点地佐辛组（t分别=10.15、3.48，P均＜0.05）。结论地佐辛预注对高龄行全髋关节置换术患者能减少术后早期认知功能障碍，降低S100-β蛋白水平。
목적：탐토지좌신예주대고령행전관치환환자술후인지공능급혈청S100-β단백수평적영향。방법선택택기전신마취전관관절수술적환자60례。수궤분위지좌신조화안위제조，매조30례，지좌신조：수술결속전30 min정맥주사지좌신0.08 mg/kg，안위제조：수술결속전30 min정맥주사동등량적0.9%록화납주사액。기록병비교량조발관시간、소성시간、시각모의동통평분（VAS）、혈청S100-β단백。결과지좌신조발관시간화소성시간교안위제조장（t분별=3.88、3.48，P균＜0.05），발관후각시간점VAS평분균비안위제조저（t분별=10.60、7.75、9.60、9.31、9.37， P균＜0.05）。술후6 h、1 d 지좌신조MMSE평분명현고우안위제조（t분별=2.04、2.28，P균＜0.05）。량조인지공능장애（POCD）적발생솔비교，차이유통계학의의（χ2=2.68，P＜0.05）。안위제조술후24 h혈청S100-β단백농도교술전1 d명현승고차고우동시점지좌신조（t분별=10.15、3.48，P균＜0.05）。결론지좌신예주대고령행전관관절치환술환자능감소술후조기인지공능장애，강저S100-β단백수평。
Objective To investigate the effect of pre injection of dezocine on cognitive function and serum S100-βpro-tein levels in elderly patients undergoing total hip replacement. Methods A total of 60 patients scheduled for total hip surgery under general anesthesia were selected and divided into dezocine group and placebo group with 30 patients in each. Dezcocine group were given dezocine 0.08mg/kg in intravenous injection at 30 minutes before surgery completed,while placebo group were given the same dose of saline. The extubation time, awaking time, visual analogue scale (VAS) and serum S100-βprotein were recorded and compared. Results Compared to placebo group, the extubation time and awak-ing time of dezocine group was longer (t=3.88,3.48,P<0.05), and the VAS score of dezocine group was lower at every point after extubation (t=10.60, 7.75, 9.60, 9.31, 9.37,P<0.05). The MMSE scores of dezocine group were significantly higher than the placebo group at 6 hours and one day after surgery (t=2.04,2.28,P<0.05). The incidence of postoperative cognitive dysfunction (POCD) of dezocine group was significantly lower than that of placebo group(χ2=2.68,P<0.05). The serum S100-β protein concentration of placebo group was significantly increased compared to one day before surgery and was higher than the concentration of dezocine group at meanwhile(t=10.15,3.48,P<0.05). Conclusion The pre injection of dezocine can reduce early cognitive dysfunction at post operation and S100-βprotein level.