右美托咪定对老年股骨颈骨折术后患者炎性反应和应激反应影响

Effect of dexmedetomidine on inflammatory and stress responses in elderly patients with femoral neck fractures after surgery

目的:探讨右美托咪定对老年股骨颈骨折术后患者炎性反应和应激反应影响。方法:选自本院于2021年6月—2023年6月老年股骨颈骨折患者86例,运用随机表法将其分为观察组(n=43)与对照组(n=43)。对照组患者于麻醉诱导前静脉输液泵注射0.5μg/kg氯化钠注射液15 min;观察组患者于麻醉诱导前静脉输液泵注射0.5μg/kg右美托咪定15 min。比较两组丙泊酚用量、手术耗时和术中出血量情况、睁眼时间和拔管时间,术后1 h、术后12 h和术后48 h疼痛情况,术前和术后24 h患者炎性反应和应激反应变化。结果:观察组丙泊酚用量少于对照组(P<0.05),而两组手术耗时和术中出血量无显著差异(P>0.05)。观察组睁眼时间和拔管时间短于对照组(P<0.05)。观察组术后1 h、12 h和48 h患者VAS评分低于对照组(P<0.05)。两组患者术前血清IL-6和CRP水平比较差异无统计学意义(P>0.05);两组患者术后24 h血清IL-6和CRP水平高于术前(P<0.05);而观察组低于对照组(P<0.05)。两组患者术前血清Cor和NE水平比较差异无统计学意义(P>0.05);两组患者术后24 h血清Cor和NE水平高于术前(P<0.05);而观察组低于对照组(P<0.05)。结论:右美托咪定对老年股骨颈骨折术后患者镇痛效果良好,可加快患者苏醒,且对炎性反应和应激反应影响小。

Objective:To explore the effects of dexmedetomidine on inflammatory and stress responses in elderly pa tients with femoral neck fractures after surgery.Methods:A total of 86 elderly patients with femoral neck fractures from June2021 to June 2023 were selected from our hospital and divided into an observation group(n=43)and a control group(n=43)using the random table method.The control group was injected with 0.5μg/kg sodium chloride injection by an intravenous in fusion pump for 15 min before anesthesia induction.The observation group was injected with 0.5μg/kg dexmedetomidine using an intravenous infusion pump for 15 min before anesthesia induction.The dosage of propofol,operation time,intraoperative blood loss,eye opening time and extubation time,pain at 1,12,and 48 h after surgery,inflammatory response,and stress response before and 24 h after surgery were compared between the two groups.Results:The propofol dosage in the observation group was lower than that in the control group(P<0.05),but there was no significant difference in the operation time and blood loss between the two groups(P>0.05).Eye opening and extubation times in the observation group were shorter than those in the control group(P<0.05).The VAS scores of the observation group at 1,12,and 48 h were lower than those of the control group(P<0.05).There was no significant difference in the serum IL-6 and CRP levels between the two groups before surgery(P>0.05).The levels of serum IL-6 and CRP 24 h after surgery were higher than those before surgery(P<0.05),and the levels in the observation group were lower than those in the control group(P<0.05).There was no significant difference in the preoperative serum Cor and NE levels between the two groups(P>0.05).The levels of serum Cor and NE 24 h after surgery were higher than those before surgery(P<0.05).The levels in the observation group were lower than those in the control group(P<0.05).Conclusion:Dexmedetomidine has a good analgesic effect on elderly patients after femoral neck fracture,can accelerate the recovery of patients,and has little effect on the inflammatory and stress responses.