丙泊酚对关节置换术患者术后认知功能障碍与早期氧化应激指标的影响

Effects of Propofol on Postoperative Cognitive Dysfunction and Early Oxidative Stress Indexes in Patients with Joint Replacement

目的:评估丙泊酚对关节置换术患者术后认知功能障碍与早期氧化应激指标的影响。方法:回顾性分析2022年1月—2024年1月山东第一医科大学第二附属医院收治的92例关节置换术患者资料,根据麻醉方法的不同将其分为研究组和对照组,各46例。对照组术中采用七氟烷维持麻醉,研究组术中采用丙泊酚维持麻醉,比较两组认知功能障碍情况、氧化应激及不良反应发生情况。结果:术后24 h,对照组简易智力状态检查量表评分低于研究组,差异均有统计学意义(P<0.05)。研究组术后认知功能障碍发生率为4.35%,低于对照组的19.57%,差异有统计学意义(P<0.05)。术后24 h,两组丙二醛、8-羟基脱氧鸟苷水平均较术前升高,但研究组均低于对照组,两组超氧化物歧化酶水平均较治疗前下降,但研究组高于对照组,差异均有统计学意义(P<0.05)。研究组不良反应发生率为4.35%,低于对照组的8.70%,但两组比较差异无统计学意义(P>0.05)。结论:丙泊酚对关节置换术患者术后认知功能障碍与早期氧化应激有积极影响,可以降低患者术后早期认知功能障碍的发生率,减轻早期氧化应激反应,且安全性良好。

Objective:To evaluate the effects of Propofol on postoperative cognitive dysfunction and early oxidative stress in patients with joint replacement.Methods:Data of 92 joint replacement patients admitted to The Second Affiliated Hospital of Shandong First Medical University from January 2022 to January 2024 were retrospectively analyzed and divided into a study group and a control group according to different anesthesia methods,46 cases in each group.Sevoflurane was used to maintain anesthesia in the control group and Propofol was used to maintain anesthesia in the study group.Cognitive dysfunction,oxidative stress and adverse reactions were compared between the two groups.Results:Twenty-four hours after operation,the Mini-Mental State Examination scores in the control group was lower than that in the study group,the difference was statistically significant(P<0.05).the incidence of postoperative cognitive dysfunction in the study group was 4.35%,which was lower than 19.57%in the control group,the difference was statistically significant(P<0.05).Twenty-four hours after surgery,malondialdehyde and 8-hydroxy-deoxyguanosine level in both groups were higher than before surgery,but the study group was lower than the control group;superoxide dismutase level in both groups was lower than before treatment,but the study group was higher than the control group,with statistical significance(P<0.05).The incidence of adverse reactions in the study group was 4.35%,lower than 8.70%in the control group,but there was no significant difference between the two groups(P>0.05).Conclusion:Propofol has a positive effect on postoperative cognitive dysfunction and early oxidative stress in patients with joint replacement surgery,which can reduce the incidence of postoperative cognitive dysfunction and alleviate early oxidative stress reaction with good safety.