德克斯梅德托米丁对功能,炎症标志物和经受关节置换手术的老年患者的认知功能的影响
Xiu-Cai Hu1, Xiao-Mei Yang2, Liang Li2
1First Department of Anesthesiology, Cangzhou Central Hospital Cangzhou 061001, Hebei, China.
American journal of translational research
|September 12, 2024
概括
在老年关节置换患者中使用德克斯梅德托米丁可以改善功能并减少炎症. 它还显著降低了手术后认知功能障碍 (POCD) 的发生率,作为对认知衰退的保护因素.
科学领域:
- 麻醉学和外科手术期间的医学.
- 腎臟病學 (nephrology) 是一種醫學.
- 老年医学 老年医学
- 神经科学是一个神经科学.
背景情况:
- 接受关节置换手术的老年患者患上术后认知功能障碍 (POCD) 的风险很高.
- 功能和炎症标志物是重大手术后患者结果的关键指标.
- 识别影响POCD的因素对于改善患者护理至关重要.
研究的目的:
- 评估德克斯梅德托米丁对功能,炎症标志物和接受关节置换的老年患者认知结果的影响.
- 在这个患者群体中确定早期术后认知功能障碍 (POCD) 的预测因子.
主要方法:
- 对接受关节置换手术的162名老年患者的回顾性分析.
- 对照组 (没有德克斯梅托米丁) 和实验组 (使用德克斯梅托米丁) 的比较.
- 评估肌素,BUN,IL-1β,TNF-α,IL-6,MoCA分数和POCD发生率;用于预测分析的逻辑回归.
主要成果:
- 与对照组 (P<0.05) 相比,德克斯梅德托米丁组显示功能 (Cr,BUN) 显著改善,炎症标志物 (IL-1β,TNF-α,IL-6) 减少.
- 实验组在手术后七天出现明显较低的POCD发病率 (P<0.05).
- 神经元特异性乙醇酶 (NSE) 水平升高 (≥7.0 pg/ml) 是POCD的危险因素,而手术内德克斯梅托米丁是保护因素 (OR=0.424).
结论:
- 术内使用德克斯梅德托米丁可减轻术后损伤和炎症反应,在接受关节置换的老年患者中.
- 德克斯梅德胺提升了认知结果,并显著降低了早期POCD的发生率和风险.
- 神经元特异性酶水平和德克斯美德托米丁的使用是影响该人口群体早期POCD的关键因素.
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