| 何金皖,吴 洁,张 燕,张 谭,林彬辉.七氟烷吸入维持全身麻醉联合右美托咪定对老年肱骨骨折患者苏醒质量、炎症介质和血清NSE、S-100?茁蛋白的影响[J].,2023,(21):4032-4036 |
| 七氟烷吸入维持全身麻醉联合右美托咪定对老年肱骨骨折患者苏醒质量、炎症介质和血清NSE、S-100?茁蛋白的影响 |
| Effects of Sevoflurane Inhalation Maintenance General Anesthesia Combined with Dexmedetomidine on Recovery Quality, Inflammatory Mediators and Serum NSE and S-100?茁 Protein in Elderly Patients with Humeral Fractures |
| 投稿时间：2023-06-16 修订日期：2023-07-12 |
| DOI：10.13241/j.cnki.pmb.2023.21.006 |
| 中文关键词: 七氟烷 全身麻醉 右美托咪定 老年 肱骨骨折 苏醒质量 炎症介质 NSE S-100β |
| 英文关键词: Sevoflurane General anesthesia Dexmetomidine Elderly Humeral fracture Recovery quality Inflammatory mediators NSE S-100β |
| 基金项目:中国红十字基金会医学赋能公益专项基金"医学赋能及人才培养计划"科研项目（CRCF-YXFN-202201075） |
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| 中文摘要: |
| 摘要 目的：探讨七氟烷吸入维持全身麻醉联合右美托咪定对老年肱骨骨折患者苏醒质量、炎症介质和血清神经元特异性烯醇化酶（NSE）、S-100β蛋白的影响。方法：选择上海市第一人民医院 2020年1月~2022年11月期间收治的老年肱骨骨折患者60例，根据随机数字表法分为对照组（吸入用七氟烷维持全身麻醉，n=30）和研究组（n=30，对照组基础上联合右美托咪定进行麻醉维持）。对比两组苏醒质量、镇痛情况、炎症介质、认知功能、血清NSE、S-100β蛋白水平和不良反应发生率。结果：与对照组相比，研究组的拔管时间、苏醒时间、复苏室停留时间更短（P<0.05）。与对照组相比，研究组术后6 h、12 h、24 h的疼痛视觉模拟评分（VAS）评分更低（P<0.05）。与对照组相比，研究组术后1 d肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）、C反应蛋白（CRP）更低（P<0.05）。与对照组相比，研究组术后1 d简易认知功能障碍量表（MMSE）评分更高，NSE、S-100β蛋白更低（P<0.05）。两组不良反应发生率组间对比无差异（P>0.05）。结论：七氟烷吸入维持全身麻醉联合右美托咪定治疗老年肱骨骨折患者，具有较好的镇痛效果，可减轻机体炎症刺激，减轻认知功能损伤，降低NSE、S-100β蛋白水平，提高苏醒质量。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the effects of sevoflurane inhalation maintenance general anesthesia combine with dexmedetomidine on recovery quality, inflammatory mediators and serum neuronspecific enolase (NSE), S-100β protein in elderly patients with humeral fractures. Methods: 60 elderly patients with humeral fractures who were admitted to Shanghai First People's Hospital from January 2020 to November 2022 were selected, and they were divided into control group (inhalation of sevoflurane maintenance general anesthesia, n=30) and study group (n=30, combined with dexmedetomidine for anesthesia maintenance on the basis of control group) according to random number table method. The recovery quality, analgesia situation, inflammatory mediators, cognitive function, serum NSE, S-100β protein levels and the incidence of adverse reaction were compared between two groups. Results: Compared with control group, study group had shorter extubation time, recovery time, and resuscitation room stay time (P<0.05). Compared with control group, study group had lower pain visual analogue scale (VAS) scores 6 h after surgery, 12 h after surgery, and 24 h after surgery (P<0.05). Compared with control group, study group had lower tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), C-reactive protein (CRP) 1 d after surgery(P<0.05). Compared with control group, study group had higher mini-mental state examination (MMSE) scores 1 d after surgery, while had lower NSE and S-100β(P<0.05). There was no difference in the incidence of adverse reactions between two groups (P>0.05). Conclusion: Sevoflurane inhalation maintenance general anesthesia combine with dexmedetomidine in the treatment in elderly patients with humeral fractures, which has a good analgesic effect, can reduce inflammatory stimulation, reduce cognitive function impairment, reduce the NSE, S-100β protein levels, and improve recovery quality. |
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