舒芬太尼复合丙泊酚对老年下肢骨科手术患者免疫功能和认知功能的影响  

Effects of Sufentanil Combined with Propofol on Immune Function and Cognitive Function in Elderly Patients Undergoing Lower Extremity Orthopedic Surgery

作　　者：马永勋 马玉清 张培 Ma Yongxun;Ma Yuqing;Zhang Pei(Department of Anesthesiology,Xinyang People’s Hospital,Xinyang,Henan,464000,China)

机构地区：[1]信阳市人民医院麻醉科,河南信阳464000

出　　处：《黑龙江医学》2024年第9期1048-1051,共4页Heilongjiang Medical Journal

基　　金：河南省医学科技攻关计划项目(182102310033)。

摘　　要：目的:分析舒芬太尼复合丙泊酚对老年下肢骨科手术患者免疫功能和认知功能的影响。方法:回顾性分析2020年1月-2022年12月信阳市人民医院收治的114例老年下肢骨科手术患者临床资料。根据手术期间浓度的异同,将患者分为舒芬太尼复合丙泊酚组、丙泊酚组和舒芬太尼组,每组各38例。对比3组患者手术前后的平均动脉压(MAP)、心率(HR)、免疫功能指标水平,对比3组患者的麻醉效果、麻醉期的认知功能以及不良反应发生率。结果:术后,3组患者MAP和HR水平均低于术前,差异有统计学意义(F=105.840、55.474,P<0.05);术后,3组患者的CD3^(+)、CD4^(+)均低于术前,差异有统计学意义(F=175.987、242.908,P<0.05);舒芬太尼组的麻醉维持时间短于舒芬太尼复合丙泊酚组,差异有统计学意义(F=3.372,P<0.05);3组患者自主呼吸时间和开始睁眼时间,差异有统计学意义(F=94.309、113.829,P<0.05);术后,3组患者MoCA评分均高于术前,差异有统计学意义(F=64.271,P<0.05)。结论:舒芬太尼复合丙泊酚应用于老年下肢骨科手术中的麻醉效果较好,有助于减轻下肢骨科手术患者的免疫反应,有利于改善患者的认知功能。Objective:To analyze the effects of Sufentanil combined with propofol on immune function and cognitive function in elderly patients with lower extremity orthopedic surgery.Methods:A retrospective analysis was made on 114 elderly patients with lower extremity orthopedic surgery admitted to the hospital from January 2020 to December 2022.All patients underwent lower extremity orthopedic surgery in the hospital.Patients were divided into sufentanil combined with propofol group,propofol group and sufentanil group according to the similarities and differences of concentration during operation,with 38 cases in each group.The mean arterial pressure(MAP),heart rate(HR)and immune function indexes before and after surgery were compared among the three groups,and the anesthetic effect,cognitive function and incidence of adverse reactions during anesthesia were compared among 3 groups.Results:Postoperative MAP,HR,CD3^(+)、CD4^(+)in sufentanil group were lower than those in sufentanil combined with propofol group and propofol group(F=105.840,55.474,175.987,242.908;P<0.05).The duration of anesthesia in sufentanil group was shorter than that in sufentanil combined with propofol group(F=3.372,P<0.05).There were statistically significant differences in the time of spontaneous breathing and the start of eye opening among the three groups(F=94.309,113.829;P<0.05).The postoperative MoCA scores of the three groups were higher than those before surgery(F=64.271,P<0.05).Conclusion:The anesthetic effect of Sufentanil combined with propofol in elderly patients with lower extremity orthopedic surgery is good.It is conducive to reducing the immune response of lung cancer patients,and improving the cognitive function of patients.

关 键 词：丙泊酚 舒芬太尼 老年下肢骨科手术 免疫功能 认知功能 

分 类 号：R683.42[医药卫生—骨科学]