瑞马唑仑复合瑞芬太尼对老年髋部骨折患者术后疼痛、炎症应激及免疫功能的影响  

Effects of remazolam combined with remifentanil on postoperative pain,inflammatory stress and immune function in elderly patients with hip fracture

作　　者：郭雪进 顾荣[1] 吉林[1] GUO Xuejin;GU Rong;JI Lin(Department of Anesthesiology,Yancheng Third People's Hospital,Yancheng,Jiangsu,China,224000)

机构地区：[1]盐城市第三人民医院麻醉科,江苏盐城224000

出　　处：《分子诊断与治疗杂志》2024年第12期2324-2328,共5页Journal of Molecular Diagnostics and Therapy

基　　金：江苏省科技项目(BL2020037)。

摘　　要：目的分析瑞马唑仑复合瑞芬太尼对老年髋部骨折患者术后疼痛、炎症应激及免疫功能的影响。方法选取盐城市第三人民医院麻醉科2021年3月到2024年5月收治的102例老年髋部骨折患者为研究对象,根据麻醉方案的差异分为联合组(n=52)和对照组(n=50),对照组给予常规麻醉药物丙泊酚麻醉,联合组给予瑞马唑仑复合瑞芬太尼麻醉。比较两组患者麻醉效果和麻醉不良反应。比较两组术前、术后6、12、24 h的的疼痛情况(VAS评分)。并比较两组术前、术后24 h的炎症应激指标(PCT、IL⁃6、CRP、Acth、INS、Glu)以及免疫功能(CD4+、CD8+、CD4+/CD8+)。结果联合组的麻醉效果Ⅰ级明显高于对照组(P<0.05)。两组术后术后6、12 h、24 h的VAS评分均比术前升高,联合组低于对照组(P<0.05)。两组术后24 h的PCT、IL⁃6、CRP、Acth、Glu均比术前升高,联合低于对照组(P<0.05)。两组术后24 h的INS、CD4+、CD4+/CD8+均比术前降低,联合组高于对照组(P<0.05)。两组术后24 h的CD8+低于术前,差异无统计学意义(P>0.05)。两组麻醉不良反应无显著差异(P>0.05)。结论瑞马唑仑复合瑞芬太尼对老年髋部骨折患者的麻醉效果较好,能有效改善术后疼痛,减轻免疫抑制及炎症应激反应。Objective To analyze the effects of remazolam combined with remifentanil on postop-erative pain,inflammatory stress and immune function in elderly patients with hip fracture.Methods A total of 102 elderly patients with hip fractures admitted to the Department of Anesthesiology at Yancheng Third People's Hospital from March 2021 to May 2024 were selected as the study subjects.Based on the differences in anesthesia protocols,they were divided into a combination group(n=52)and a control group(n=50).The control group received propofol anesthesia.While the combination group received remazolam combined with remifentanil.The anesthetic effects and adverse reactions were compared between the two groups.The pain lev-els of both groups before surgery,6,12h and 24h after surgery were evaluated using the VAS score.Inflamma-tory stress indexes(PCT,IL-6,CRP,ACTH,INS,Glu)and immune function(CD4+,CD8+,CD4+/CD8+)were compared between the two groups before and 24 hours after surgery.Results The effect of grade I anesthesia in the combination group was significantly higher than that in the control group(P<0.05).The VAS scores at 6,12 h,and 24 h for both groups were higher than those before surgery,with the combined group showing lower scores than the control group.Levels of CRP,ACTH,and Glu in both groups were higher than before surgery 24 h after surgery,but lower than those in the control group(P<0.05).The levels of INS,CD4+,and CD4+/CD8+in both groups at 24 h after surgery were lower than before surgery,with the combi-nation group showing higher levels compared to the control group(P<0.05).CD8+levels in both groups 24 h after surgery were lower than before surgery(P<0.05),with no significant difference between the two groups(P>0.05).There were no significant differences in adverse anesthesia reactions between the two groups(P>0.05).Conclusion Remazolam combined with remifentanil has a beneficial anesthetic effect on elderly pa-tients with hip fracture.It can effectively improve postoperative pain,reduce immune suppression and al

关 键 词：瑞马唑仑 瑞芬太尼 老年髋部骨折 术后疼痛 炎症应激 

分 类 号：R614[医药卫生—麻醉学]