纳布啡复合舒芬太尼PCIA对老年股骨骨折患者PFNA术后镇痛、认知功能和血清炎症因子的影响  

Effects of Nalbuphine Combined with Sufentanil PCIA on Postoperative Analgesia,Cognitive Function and Serum Inflammatory Factors in Elderly Patients with Femoral Fracture after PFNA

作　　者：蔡瑞卿 刘丽贤 钟启钊 陈旭 付建强 谢长春 CAI Ruiqing;LIU Lixian;ZHONG Qizhao;CHEN Xu;FU Jianqiang;XIE Changchun(Department of Anesthesiology,Guangzhou Liwan Central Hospital,Guangzhou 510175,Guangdong,China)

机构地区：[1]广州市荔湾中心医院麻醉科,广东广州510175

出　　处：《中国药物滥用防治杂志》2024年第12期2179-2180,2183,共3页Chinese Journal of Drug Abuse Prevention and Treatment

基　　金：广东省广州市荔湾区卫生系统重点专科建设项目(编号:201804003)。

摘　　要：目的:探讨纳布啡复合舒芬太尼自控静脉镇痛(PCIA)对老年股骨骨折患者股骨近端抗旋髓内钉(PFNA)术后镇痛、认知功能和血清炎症因子的影响。方法:选取我院2023年1—12月就诊的150例老年股骨骨折患者,采用数字随机法将患者分为对照组与观察组,每组75例;对照组术后采用舒芬太尼自控静脉镇痛,观察组采用纳布啡复合舒芬太尼自控静脉镇痛。对比两组术后镇痛情况、认知能力情况、炎症因子情况、镇痛泵按压次数以及不良反应情况。结果:观察组术后1、6、12、24、48 h的VAS评分低于对照组,差异有统计学意义(P<0.05);观察组术后1、2、3 d的MMSE评分与对照组比较,差异无统计学意义(P>0.05);术后两组TNF-α、IL-6、IL-10含量均较术前上升,但观察组TNF-α、IL-6、IL-10含量均优于对照组,差异有统计学意义(P<0.05);观察组术后镇痛泵按压次数少于对照组,差异有统计学意义(P<0.05);观察组不良反应发生率与对照组比较,差异无统计学意义(P>0.05)。结论:老年股骨骨折患者接受PFNA术后,采用纳布啡复合舒芬太尼PCIA不仅有效地减轻了患者的术后疼痛感,还可降低术后炎症反应,减少术后镇痛泵按压次数,且不增加不良反应发生几率。Objective:To investigate the effects of patient-controlled intravenous analgesia(PCIA)with nalbuphine combined with sufentanil on postoperative analgesia,cognitive function and serum inflammatory factors in elderly patients with femoral fracture after proximal femoral nail anti-rotation(PFNA).Methods:A total of 150 elderly patients with femoral fractures who were treated in our hospital from January to December 2023 were selected.The patients were divided into control group and observation group by digital random method,with 75 patients in each group.The control group was treated with sufentanil patient-controlled intravenous analgesia,and the observation group was treated with nalbuphine combined with sufentanil patient-controlled intravenous analgesia.The postoperative analgesia,cognitive ability,inflammatory factors,analgesic pump pressing times and adverse reactions were compared between the two groups.Results:The VAS scores of the observation group at 1,6,12,24 and 48 h after operation were lower than those of the control group,and the differences were statistically significant(P<0.05).There was no significant difference in MMSE score between the observation group and the control group at 1,2 and 3 days after operation(P>0.05).After operation,the contents of TNF-α,IL-6 and IL-10 in the two groups were higher than those before operation,but the contents of TNF-α,IL-6 and IL-10 in the observation group were better than those in the control group,and the differences were statistically significant(P<0.05).The number of postoperative analgesia pump pressing in the observation group was less than that in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the observation group and the control group(P>0.05).Conclusion:After PFNA surgery in elderly patients with femoral fractures,PCIA with nalbuphine combined with sufentanil not only effectively reduces the postoperative pain of patients,but also reduces the po

关 键 词：纳布啡 舒芬太尼 股骨骨折 自控静脉镇痛 

分 类 号：R68[医药卫生—骨科学]