依达拉奉对老年患者膝关节置换术后认知功能的影响  

Effects of edaravone on postoperative cognitive function in elderly patients undergoing knee replacement surgery

作　　者：谭宇桔 徐志鹏[1] 姜雨鸽[1] 张宏[1] 

机构地区：[1]解放军总医院麻醉手术中心,北京100853

出　　处：《解放军医学院学报》2015年第5期473-476,共4页Academic Journal of Chinese PLA Medical School

基　　金：总后勤部卫生部保健专项科研课题(13BJZ38)~~

摘　　要：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（minimental 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。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.

关 键 词：依达拉奉 老年人 膝关节置换术 术后认知功能障碍 

分 类 号：R614[医药卫生—麻醉学]