帕瑞昔布钠预防性给药对老年创伤患者在重症监护室术后谵妄发生的影响  

Effect of prophylactic administration of parecoxib sodium on postoperative delirium in elderly trauma patients in intensive care unit

作　　者：谭沁 黄巍峰[1] TAN Qin;HUANG Weifeng(Shanghai Jiao Tong University Afiliated Sixth People’s Hospital 200233,China)

机构地区：[1]上海交通大学附属第六人民医院重症医学科,上海200030

出　　处：《中国急救复苏与灾害医学杂志》2020年第7期832-835,共4页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：科技部数字诊疗重点专项(编号:2017YFC0113800);上海市综合医院中西医结合专项(编号:ZHYY-ZXYJHZX-2-2017010);上海市浦江计划(编号:18PJ1409200)。

摘　　要：目的本研究目的在于评价帕瑞昔布钠的超前给药对老年创伤患者术后,在重症监护病房发生谵妄的影响。方法在这项前瞻性、单中心、随机、双盲、安慰剂对照试验中,一共纳入了109名自2019年6-12月收治于上海交通大学附属第六人民医院骨科并计划在术后进入重症监护病房的老年创伤患者。随机将符合标准的患者分为安慰剂组(A组)和帕瑞昔布钠组(B组),分别在术前给予生理盐水或帕瑞昔布钠40 mg。谵妄评估采用意识模糊评估法中文修订版。主要观察指标为术后48h内谵妄的发生率,谵妄平均分和疼痛平均分。另外研究期间监测入组患者不良事件的发生,包括消化道出血、心血管事件、伤口感染。结果在109例患者中,有36例发生了术后谵安(33%),B组的发生率明显低于A组(43.8%vs.21.2%,P=0.015);B组的谵妄平均分和疼痛平均分均小于A组(P<0.05)。两组患者术后均未发生严重的不良事件。结论术前预防性给予帕瑞昔布钠可以有效降低老年骨科患者术后谵妄的发生率。Objective To evaluate the ffet of prophylactic administration of parecoxib sodium on postoperative delirium of elderly orthopedic patients in the intensive care unit(ICU).Methods In this prospective,single-center,randomized,doubleblind,placebo-controlled trial,a total of 109 elderly trauma patients were ineluded,from June to December 2019,admitted to our hospital and planned to enter the ICU postoperatively.Patients were randomLy divided into placebo group(group A)and parecoxib sodium group(group B)with normal saline or parecoxib sodium 40 mg given respectively before operation.The outcomes were the incidence of delirium within 48 hrs after operation,the average delirium and average pain scores.During the study,incidence of adverse events were closely monitored,including gastrointestinal hemorrhage,cardiovascular events and wound infection.Results Finally,36 of 109 patients developed POD(33%),of which the incidence of group B was significantly lower than that of group A(43.8%vs.21.2%,P=0.015).The average delrium scores and pain scores of group B were lower than that of group A(P<0.05).No adverse events occurred in the both two groups.Conclusion Prophylactic administration of parecoxib can effectively reduce the ineidence of postoperative delirium in elderly orthopedic patients.

关 键 词：术后谵妄 帕瑞昔布钠 创伤 预防性给药 

分 类 号：R74[医药卫生—神经病学与精神病学]