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胡亦玮 曹 寅▲.丹参川芎嗪注射液对老年患者全膝关节置换术后谵妄的影响[J].中国现代医生,2021,59(4):18-22
丹参川芎嗪注射液对老年患者全膝关节置换术后谵妄的影响
Effect of Salviae Miltiorrhizae and Ligustrazine Hydrochloride Injection on delirium after total knee arthroplasty in elderly patients
  
DOI:
中文关键词:  丹参川芎嗪注射液  脑氧饱和度  术后谵妄  血液高凝状态
英文关键词:Salviae Miltiorrhizae and Ligustrazine Hydrochloride Injection  Cerebral oxygen saturation  Postoperative delirium  Blood hypercoagulability
基金项目:浙江省宁波市公益类科技计划项目(2019C50079)
作者单位
胡亦玮 曹 寅▲ 宁波市第一医院江北分院(宁波市第九医院)麻醉科浙江宁波 315000 
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中文摘要:
      目的观察丹参川芎嗪注射液对老年患者全膝关节置换术后谵妄(POD)的影响。方法 选取2019 年2—10 月宁波市第一医院接受单侧全膝关节置换术的老年患者68 例,所有患者被分为研究组和对照组,每组各34 例。研究组患者给予加入了10 mL 丹参川芎嗪注射液的5%葡萄糖溶液250 mL;对照组患者给予250 mL 5%葡萄糖溶液。记录所有患者术前合并症、手术时间、总失血量、总输血量。术前第3 天(T1)、手术当天(T2)、术后第1 天(T3)、术后第2 天(T4)、术后第3 天(T5)检测患者脑氧饱和度(rSO2)、动脉血氧分压(PaO2)、血红蛋白(Hb)水平。T3、T4、T5时点采用谵妄分级量表(DRS)评估患者POD 发生率及DRS 严重程度。结果 两组患者中合并术前认知障碍、COPD、脑卒中病史患者例数及手术时间、总失血量、总输血量比较,差异无统计学意义(P>0.05)。T1~T5时,两组患者PaO2及Hb 水平比较,差异无统计学意义(P>0.05),T1、T2时两组患者rSO2水平比较,差异无统计学意义(P>0.05)。T3~T5时,研究组患者rSO2水平显著高于对照组,DRS 严重程度评分均低于对照组(P<0.05)。T3、T4时,研究组POD 发生率低于对照组(P<0.05)。结论在全膝关节置换术中,丹参川芎嗪注射液可提高老年患者术后rSO2,降低术后POD 发生率,还能减轻其严重程度。
英文摘要:
      Objective To observe the effect of Salviae Miltiorrhizae and Ligustrazine Hydrochloride Injection on postoperative delirium(POD) after total knee arthroplasty in elderly patients.Methods A total of 68 elderly patients who underwent unilateral total knee arthroplasty from February to October 2019 in Ningbo First Hospital were selected.All patients were divided into study group and control group,with 34 cases in each group.Patients in the study group were given 250 mL of 5% glucose solution with 10 mL of Salviae Miltiorrhizae and Ligustrazine Hydrochloride Injection.Patients in the control group were given 250 mL of 5% glucose solution.The preoperative complications,operation time,total blood loss,and total blood transfusion of all patients were recorded.On the 3rd day before the operation(T1),the day of the operation(T2),the first day after the operation(T3),the second day after the operation(T4),and the third day after the operation(T5),the cerebral regional oxygen saturation(rSO2),arterial partial pressure of oxygen(PaO2),and hemoglobin(Hb) levels were detected.At T3,T4and T5,the delirium rating scale (DRS) was used to evaluate the incidence of POD and the severity of DRS.Results There was no significant difference in the number of patients with preoperative cognitive impairment,COPD,stroke history,and operation time,total blood loss and total blood transfusion between the two groups(P>0.05).From T1to T5,there was no significant difference in PaO2and Hb levels between the two groups(P>0.05).There was no significant difference in rSO2levels between the two groups at T1and T2(P>0.05).From T3to T5,the rSO2levels of the study group was significantly higher than that of the control group,and the DRS severity score was lower than that of the control group(P<0.05).At T3and T4,the incidence of POD in the study group was lower than that in the control group(P<0.05).Conclusion In total knee arthroplasty,Salviae Miltiorrhizae and Ligustrazine Hydrochloride Injection can increase postoperative rSO2in elderly patients,reduce the incidence of POD,and can reduce its severity.
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