艾司西酞普兰联合帕瑞昔布钠对老年骨折术后患者心理状态及认知功能的影响

Effect of escitalopram combined with parecoxib sodium on psychological status and cognitive function in elderly patients with fractures

目的探讨艾司西酞普兰联合帕瑞昔布钠对老年骨折术后患者心理状态及认知功能的影响。方法选取2018年1月~2019年1月在我院接受骨折手术的老年患者97例作为本次研究的主体对象,按随机数字表法将研究对象随机分为观察组和对照组,对照组(48例)手术结束前给予帕瑞昔布钠静推镇痛,观察组(49例)在对照组基础上增加艾司西酞普兰口服治疗。观察比较两组患者疼痛介质、机体应激反应、炎症因子、VAS、HAMD、HAMA、MMSE评分。结果(1)与麻醉前相比,观察组患者术后Cor、NO、CRP、PGE2、5-HT水平较前降低(P<0.05),且与对照组相比,观察组患者5-HT水平降低更明显(P<0.05);(2)术后14d,两组患者HAMD、HAMA评分较前降低(P<0.05),且与对照组相比,观察组患者HAMD评分及HAMA评分降低明显(P<0.05);(3)观察组患者术后VAS评分低于对照组,MMSE评分高于对照组(P<0.05)。结论艾司西酞普兰联合帕瑞昔布钠不仅能有效减轻老年骨折患者术后疼痛,还能缓解患者焦虑抑郁情绪,促进认知功能恢复。

Objective To investigate the effect of escitalopram combined with parecoxib sodium on psychological status and cognitive function in elderly patients with fractures.Methods A total of 97 elderly patients undergoing surgical treatment of fractures in our hospital from January 2018 to January 2019 were collected and randomly divided into two groups:the control group(48 cases)received parecoxib sodium for static analgesia before the end of surgery,and the observation group(49 cases)received escitalopram orally on the basis of the control group.The pain mediators,body stress response,inflammatory factors,VAS,HAMD,HAMA and MMSE scores between the two groups were compared.Results(1)Compared with before anesthesia,postoperative Cor,NO,CRP,PGE2 and 5-HT levels in the observation group were lower(P<0.05),and the 5-HT levels in the observation group were significantly lower than that in the control group(P<0.05).(2)14 d after surgery,HAMD and HAMA scores in the two groups were lower(P<0.05),and compared with the control group,HAMD and HAMA scores in the observation group were significantly lower(P<0.05).(3)Postoperative VAS score in the observation group was lower than that in the control group,and MMSE score in the observation group was higher than that in the control group(P<0.05).Conclusion Escitalopram combined with parecoxib sodium can not only effectively reduce postoperative pain in elderly patients with fracture,but also relieve anxiety and depression and promote the recovery of cognitive function.