托烷司琼复合舒芬太尼静脉自控镇痛对老年膝关节置换术患者的影响  

Effect of Tropisetron Combined with Sufentanil Intravenous Controlled Analgesia on Elderly Patients with Knee Replacement

作　　者：乔洪波 QIAO Hongbo

机构地区：[1]临沂市精神卫生中心(临沂市第四人民医院)手术麻醉科,山东临沂276002

出　　处：《中国医学创新》2024年第35期110-114,共5页Medical Innovation of China

摘　　要：目的:探究托烷司琼复合舒芬太尼静脉自控镇痛在老年膝关节置换术患者中的应用效果。方法:选择2021年12月—2023年12月临沂市精神卫生中心收治的82例老年膝关节置换术患者作为研究对象,采用随机数字表法将其分为对照组和观察组,各41例。对照组术后给予舒芬太尼静脉自控镇痛,观察组术后给予托烷司琼复合舒芬太尼静脉自控镇痛。比较两组术后认知功能[简易智能量表(MMSE)]、镇痛评分[数字评定量表(NRS)]、炎症反应[白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)]、胃肠激素[胃泌素(GAS)、胃动素(MTL)、血管活性肠肽(VIP)]及不良反应发生情况。结果:术后72 h、7 d,观察组MMSE评分均高于对照组,7 d内认知障碍发生率低于对照组,差异均有统计学意义(P<0.05)。术后1、12、24 h,观察组NRS评分均低于对照组,差异均有统计学意义(P<0.05)。麻醉诱导前(T_(0)),两组IL-6、IL-10、TNF-α比较,差异均无统计学意义(P>0.05);术毕(T_(1))、术后6 h(T_(2))、术后24 h(T_(3)),两组IL-6、IL-10、TNF-α均高于T_(0),且观察组IL-6、TNF-α均低于对照组,IL-10均高于对照组,差异均有统计学意义(P<0.05)。术前,两组GAS、MTL、VIP比较,差异均无统计学意义(P>0.05);术后1、3 d,两组GAS、MTL均低于术前,VIP均高于术前,且观察组GAS、MTL均高于对照组,VIP均低于对照组,差异均有统计学意义(P<0.05)。结论:托烷司琼复合舒芬太尼静脉自控镇痛可减轻膝关节置换术患者炎症反应,增强镇痛效果,降低认知障碍发生率,改善胃肠功能,减少不良反应。Objective:To explore the effect of Tropisetron combined with Sufentanil intravenous controlled analgesia in elderly patients with knee replacement.Method:A total of 82 elderly patients with knee replacement treated in Linyi Mental Health Center from December 2021 to December 2023 were selected as the study objects,and they were divided into control group and observation group by random number table method,with 41 cases in each group.The control group was given Sufentanil intravenous controlled analgesia after surgery,and the observation group was given Tropisetron combined with Sufentanil intravenous controlled analgesia after surgery.Postoperative cognitive function[mini-mental state examination(MMSE)],analgesia score[numeric rating scale(NRS)],inflammatory response[interleukin-6(IL-6),interleukin-10(IL-10),tumor necrosis factor-α(TNF-α)],gastrointestinal hormones[gastrin(GAS),motilin(MTL),vasoactive intestinal peptide(VIP)]and the occurrence of adverse reactions were compared between the two groups.Result:At 72 h and 7 d after surgery,MMSE scores in observation group were higher than those in control group,and the incidence of cognitive impairment within 7 d was lower than that in control group,the differences were statistically significant(P<0.05).At 1,12 and 24 h after surgery,NRS scores in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).Before anesthesia induction(T_(0)),there were no significant differences in levels of IL-6,IL-10 and TNF-αbetween the two groups(P>0.05).After surgery(T_(1)),6 h after surgery(T_(2))and 24 h after surgery(T_(3)),levels of IL-6,IL-10 and TNF-αin two groups were higher than those T_(0),while levels of IL-6 and TNF-αin observation group were lower than those in control group,and levels of IL-10 were higher than those in control group,the differences were statistically significant(P<0.05).Before surgery,there were no significant differences in levels of GAS,MTL and VIP between the two groups(P>0.05).On t

关 键 词：托烷司琼 舒芬太尼 静脉自控镇痛 老年患者 膝关节置换术 认知功能 

分 类 号：R614[医药卫生—麻醉学]