右美托咪定可减轻髋关节置换老年患者的炎症反应  

Dexmedetomidin relieves inflammatory response in the aged patients after hip replacement

作　　者：宋海明[1] 马靖华[1] 陈晖[2] 

机构地区：[1]唐山市第二医院麻醉科,河北省唐山市063000 [2]河北联合大学附属医院口腔科,河北省唐山市063000

出　　处：《中国组织工程研究》2015年第44期7077-7081,共5页Chinese Journal of Tissue Engineering Research

摘　　要：背景:人工髋关节置换是老年患者的常见手术,右美托咪定对置换后炎症反应的镇静调控作用受到了越来越多的重视。目的:观察右美托咪定对髋关节置换老年患者炎症反应的影响,以期为患者炎症镇静提供理论参考。方法:选择100例人工髋关节置换后的老年患者,年龄60-75岁。通过随机数字表法分为两组,对照组和观察组各50例。对照组镇静应用咪达唑仑注射液静脉注射,观察组镇静使用右美托咪定注射液静脉注射。对比观察两组患者置换前(T0)、置换后24 h(T1)、48 h(T2)3个观察时点C-反应蛋白、肿瘤坏死因子α及白细胞计数等炎症指标及Ramsay镇静评分变化。结果与结论:T1时两组白细胞计数水平呈现增高趋势,C-反应蛋白、肿瘤坏死因子α水平均有所下降,组间比较差异无显著性意义(P>0.05)。在T2时,观察组白细胞计数明显升高(P<0.05),而对照组已逐渐恢复至T0水平。T2时两组C-反应蛋白、肿瘤坏死因子α较T1时均有所下降(P<0.05),但观察组下降程度大于对照组。观察组在T1、T2时点Ramsay镇静评分明显高于对照组,差异有显著性意义(P<0.01)。说明右美托咪定用于髋关节置换后镇静可减轻机体的炎症反应,有利于患者髋关节功能的恢复。BACKGROUND： Hip replacement surgery is a common surgery in elderly patients. Regulatory effect of dexmedetomidin on inflammatory response in the aged patients after hip replacement attracted more and more attention. OBJECTIVE： To observe the effects of dexmedetomidin on inflammatory response in aged patients undergoing hip replacement, and to provide theoretical reference for inflammatory sedation. METHODS： 100 elderly patients aged from 60 to 75 years with hip replacement surgery were randomly divided into control group and observation group（n=50）. The control group intravenously received midazolam injection. The observation group received dexmedetomidin injection. Changes in inflammatory markers, such as C-reactive protein, tumor necrosis factor-α and leukocyte count and Ramsay sedation score changes were compared and observed between the two groups before replacement（T0）, 24 hours（T1） and 48 hours（T2） after replacement. RESULTS AND CONCLUSION： Leukocyte level presented an increased trend in both groups at T1. C-reactive protein and tumor necrosis factor-α levels decreased, and no significant difference was detected between the two groups（P〉0.05）. At T2, leukocyte levels were significantly increased in the observation group（P〈0.05）, and leukocyte levels were gradually returned to T0 level in the control group. C-reactive protein and tumor necrosis factor-α levels were lower at T2 than at T1 in both groups（P〈0.05）. However, the decreased degree was bigger in the observation group than in the control group. Ramsay sedation score was significantly higher in theobservation group than in the control group at T1 and T2（P〈0.01）. These findings indicate that dexmedetomidine for sedation after hip replacement can lessen inflammatory response and contribute to the recovery of hip function.

关 键 词：右美托咪啶 关节成形术 置换 髋 炎症 组织工程 骨科植入物 人工假体 右美托咪定 髋关节置换 老年 炎症反应 C-反应蛋白、肿瘤坏死因子α 白细胞计数 

分 类 号：R318[医药卫生—生物医学工程]