血必净注射液对老年患者关节置换术后早期认知功能的影响

Effects of Xuebijing injection on early postoperative cognitive function in elderly patients with hip replacement

目的探讨血必净注射液对老年患者关节置换术后早期认知功能的影响。方法选取择期行全髋关节置换术的老年患者60例,随机分为血必净组(X组,n=30)和对照组(C组,n=30)。X组手术前30 min血必净注射液50 mL+生理盐水100 mL静滴,术后血必净注射液50 mL+生理盐水100 mL静滴,每天2次,连用5 d;C组等量生理盐水静脉滴注。检测两组患者不同时间点血清中C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)的浓度。术前1 d、术后7 d采用简易精神状态检查量表(MMSE)对患者进行认知功能测试。结果两组患者手术后CRP、IL-6、TNF-α明显增高(P<0.05),X组增高的幅度低于C组(P<0.05);两组术后认知功能障碍(POCD)的发生率比较差异无统计学意义,术后X组的MMSE评分高于C组(P<0.05)。结论围术期静滴血必净注射液可抑制术后炎性细胞因子CRP、IL-6、TNF-α等的释放,降低麻醉及手术创伤的应激反应,改善老年患者关节置换术后早期认知功能。

Objective To explore the effects of Xuebijing injection on early postoperative cognitive func- tion in elderly patients with hip replacement. Methods Sixty elderly patients were randomly divided into Xuebi- jing group （group X, n = 30） and control group （group C, n = 30）. At 30 min before incision, patients in Group X and C were intravenously injected with 50 mL Xuebijing injection and saline respectively. The patients in group X received Xuebijing injection 50 mL twice a day for five days after surgery and the group C were injected with saline. The concentration of C-reactive protein （CRP）, interleukin-6 （IL-6） and tumor necrosis factor-α （TNF-α） were detected in serum at different time points. MMSE was used to access the cognitive function of the patients before surgery and 7 d after operation. Result The levels of CRP, IL-6 and TNF-α increased after operation. The extent of increasing in group X were significantly lower than that in group C （P 〈 0.05 ）. There was no significant difference between the two groups in the incidence of POCD. MMSE scores in Group X was higher than that in Group C after operation. Conclusion Xuebijing injection can inhibit the release of inflammatory cytokines such as CRP, IL-6 and TNF-α. It also helps elderly patients to improve cognitive function in early stage after operation.