超声引导下腰骶丛神经阻滞对老年全髋关节置换术后认知功能及血清应激、炎症指标的影响

Effects of Ultrasound-Guided Lumbosacral Plexus Block on Cognitive Function and Serum Stress and Inflammatory Indexes after Total Hip Arthroplasty in Elderly Patients

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DOI
刊名
Journal of International Psychiatry
年,卷(期) 2023, 50(1)
作者
作者单位

河南省三门峡市中心医院 ;

摘要
【摘要】探讨超声引导下腰骶丛神经阻滞对老年全髋关节置换术(THR)后认知功能及血清应激、炎症指标的影响。方法 本研究对象为我院2021年4月-2022年4月60例老年THR术患者,随机均分为两组,对照组采用常规全麻,观察组在对照组基础上采用超声引导下腰骶丛神经阻滞。记录两组患者术前、术后1d、3d、7d时简易精神状态检查(MMSE)评分,检测术前、术后1d、3d、7d时血清皮质醇(Cor)、肿瘤坏死因子(TNF-α)、白细胞介素6(IL-6)等应激与炎症指标水平,记录术后认知功能障碍、谵妄等并发症发生情况。结果 两组术后1d、3d MMSE评分均显著低于术前,但观察组术后1d、3d显著高于对照组,(P<0.05),两组术后7d与术前比较、术后7d组间比较差异无统计学意义(P>0.05);两组术后1d、3d、7d血清Cor、TNF-α、IL-6水平均显著高于术前,但观察组术后1d、3d显著低于对照组,(P<0.05),两组术后7d组间比较差异无统计学意义(P>0.05);观察组术后认知功能障碍、谵妄发生率显著低于对照组,(P<0.05)。结论 超声引导下腰骶丛神经阻滞能够减轻老年THR术后认知功能损害,减轻应激及炎症反应,降低认知功能障碍、谵妄等并发症发生率。
Abstract
[Abstract] Objective To investigate the effect of ultrasound-guided lumbosacral plexus block on cognitive function, serum stress and inflammatory indexes after total hip arthroplasty (THR) in the elderly. Methods Sixty elderly THR patients in our hospital from April 2021 to April 2022 were selected as the study subjects. They were randomly divided into two groups. The control group was given conventional general anesthesia, and the observation group was given ultrasound-guided lumbosacral plexus block on the basis of the control group. The scores of the Mini-Mental State Examination (MMSE) were recorded before the operation, 1d, 3d, and 7d after the operation in the two groups. The levels of serum cortisol (Cor), tumor necrosis factor (TNF-α), interleukin 6 (IL-6) and other stress and inflammatory indexes were detected before surgery, 1d, 3d, and 7d after surgery. Postoperative complications such as cognitive impairment and delirium were recorded. Results The MMSE scores of the two groups at 1d and 3d after operation were significantly lower than those before operation, but the observation group was significantly higher than the control group at 1d and 3d after operation (P<0.05). There was no significant difference between the two groups at 7 days after operation and before operation, and between the two groups at 7 days after operation (P>0.05). The serum levels of Cor, TNF-α and IL-6 in the two groups were significantly higher than those before operation at 1d, 3d and 7d after operation, but the observation group was significantly lower than the control group at 1d and 3d after operation (P<0.05). There was no significant difference between the two groups at 7 days after operation (P>0.05). The incidences of postoperative cognitive dysfunction and delirium in the observation group were significantly lower than those in the control group (P<0.05). Conclusion Ultrasound-guided lumbosacral plexus block can reduce the cognitive impairment, stress and inflammatory response in elderly patients after THR, and reduce the incidence of complications such as cognitive dysfunction and delirium.
关键词
关键词:超声引导下腰骶丛神经阻滞;老年全髋关节置换术;认知功能;应激反应;炎症反应
KeyWord
Key words Ultrasound-Guided Lumbosacral Plexus Block; Total Hip Arthroplasty in the Elderly; Cognitive Function; Stress Response; Inflammatory Response
基金项目
页码 128-131
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刘涛*. 超声引导下腰骶丛神经阻滞对老年全髋关节置换术后认知功能及血清应激、炎症指标的影响 [J]. 国际精神病学杂志. 2023; 50; (1). 128 - 131.

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