不同镇静深度对老年骨折患者术后炎症因子以及术后认知功能的影响

doi:10.3969/j.issn.1671-7171.2021.11.018

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Abstract 【Objective】To investigate the effects of different sedation depths on postoperative inflammatory factors and postoperative cognitive function in elderly patients with fractures. 【Methods】A total of 200 fracture patients in our hospital were randomly divided into A and B groups. Patients in both groups were given general anesthesia. Bispectral index(BIS )was maintained at 40-49 in the group A and 50-59 in the group B. The changes of awake time, extubation time, orientation recovery time, cognitive function recovery and serum inflammatory factors were compared between the two groups. 【Results】The awake time, extubation time and orientation recovery time of group A were shorter than those of group B (P<0.05).There was no significant difference in MMSE scores between the two groups before operation (P>0.05). The MMSE scores of the two groups were lower than those before operation (P<0.05). The MMSE scores of group A were higher than those of group B at each time point (P<0.05). The incidence of cognitive dysfunction in group A was lower than that in group B at 1d, 3d and 7d after operation(P<0.05).There were no significant differences in the levels of interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α) and central nervous system specific protein (S100β) between the two groups before surgery (P>0.05). After operation, the levels of IL-6, TNF-α and S100β in the two groups were higher than those before operation. The levels of IL-6, TNF-α and S100β were lower than those in group B at each time point (P<0.05). 【Conclusion】In elderly patients, intraoperative BIS values of 40-49 can effectively reduce the impact on cognitive function, shorten postoperative waking time and recovery time, reduce immune stress response, and reduce the release of inflammatory factors.

Key words： Fractures, Bone/SU Deep Sedation Aged Cognition Inflammation Mediators

Received: 06 November 2019

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http://journal07.magtech.org.cn/yxlcyj/EN/10.3969/j.issn.1671-7171.2021.11.018 OR http://journal07.magtech.org.cn/yxlcyj/EN/Y2021/V38/I11/1667

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