七氟醚静吸复合麻醉对行髋关节置换术的股骨颈骨折患者麻醉质量及认知功能的影响  

Effect of sevoflurane combined intravenous inhalational anesthesia on anesthesia quality and cognitive function in patients with femoral neck fractures performed with hip arthroplasty

作　　者：马艳玲 陈秋 冯锋 Ma Yan-ling;Chen Qiu;Feng Feng(Department of Anesthesia and Perioperative Medicine,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学附属郑州中心医院麻醉与围术期医学科,河南郑州450000

出　　处：《四川生理科学杂志》2024年第1期48-50,60,共4页Sichuan Journal of Physiological Sciences

摘　　要：目的:以髋关节置换术(Hip Arthroplasty,HÀ)治疗的股骨颈骨折(Femoral neck fracture,FNF)患者为研究对象,分析七氟醚静吸复合麻醉的临床优势,为麻醉方式的选择提供参考。方法:选取2020年8月至2021年8月我院98例实施HA的FNF患者,随机分为两组,各49例。全凭组采用全凭静脉麻醉,复合组采用七氟醚静吸复合麻醉。比较两组苏醒质量,麻醉前(T0)、麻醉后10 min(T1)、切皮时(T2)、术毕(T3)时平均动脉压(Mean arterial pressure,MAP)、血氧饱和度(Saturation of blood oxygen,SPO2),术前、术后血清髓鞘碱性蛋白(Myelin basic protein,MBP)、神经生长因子-β(Nerve growth factor-β,NGF-β)、S100β蛋白(Soluble protein-100β,S100β)水平,术前、术后认知功能(蒙特利尔认知评估量表(Montreal Cognitive Assessment,MOCA)评分)。结果:复合组苏醒时间、自主呼吸时间、言语应答时间及定向力恢复时间均较全凭组短(P<0.05);T1、T2时两组MAP、SPO2均较T0升高,且复合组低于全凭组(P<0.05),T3时复合组MAP低于全凭组(P<0.05);术后,两组NGF-β均降低,复合组高于全凭组,MBP、S100β均升高,复合组低于全凭组(P<0.05);术后2 h、6 h、24 h复合组MOCA评分高于全凭组(P<0.05)。结论:HA治疗FNF时采用七氟醚静吸复合麻醉能提高麻醉质量,稳定血流动力学,减轻神经功能损伤,有助于改善认知功能。Objective:To analyze the clinical advantages of sevoflurane combined intravenous inhalational anesthesia in patients with femoral neck fracture(FNF)treated by hip arthroplasty(HA)and to provide reference for the selection of anesthesia modality.Methods:98 patients with FNF performed HA in our hospital from August 2020 to August 2021 were selected and divided randomly.into two groups,with 49 patients in each group.The all-voucher group was anesthetized with all-voucher intravenous anesthesia;the composite group was anesthetized with sevoflurane combined intravenous inhalational anesthesia.The anesthesia quality,the mean arterial pressure(MAP)and saturation of blood oxygen(SPO2)before anesthesia(T0)/10 min after anesthesia(T1)/the time of skin incision(T2)/the end of surgery(T3),Myelin basic protein(MBP),nerve growth factor-β(NGF-β),and S100β(S100β)levels and the cognitive function(Montreal Cognitive Assessment,MOCA)before and after surgery were compared between the two groups.Results:Time to awaken,time to spontaneous breathing,time to speech response and time to recovery of orientation in the composite group were shorter than those in all-voucher group(P<0.05);compared to T0,MAP and SPO2 were higher in both groups at T1 and T2,and the indexes in the composite group were lower than those in the full voucher group(P<0.05),and MAP in the composite group was lower than that in the full voucher group at T3(P<0.05).after surgery,the levels of NGF-βwere lower in both groups;and the levels of NGF-βin the composite group were lower than those in the full voucher group;the levels of MBP and S100βwere higher in both groups;and their levels in the composite group were lower than those in the full voucher group(P<0.05);at 2 h,6 h and 24 h after surgery,MOCA scores in the composite group were higher than those in the full voucher group(P<0.05).Conclusion:Sevoflurane combined intravenous inhalational anesthesia used in FNF performed HA could enhance the quality of anesthesia,stabilize the hemodynamics,reduce neurological

关 键 词：股骨颈骨折 七氟醚 认知功能 

分 类 号：R614[医药卫生—麻醉学]