|
| 氢气吸入对老年患者髋部骨折术后谵妄的影响 |
| Effect of hydrogen gas inhalation on postoperative delirium in elderly patients receiving hip fracture surgery |
| |
| DOI：10.12089/jca.2018.07.005 |
| 中文关键词: 氢气吸入 老年患者 术后谵妄 炎症反应 |
| 英文关键词: Hydrogen gas inhalation Elderly patients Postoperative delirium Inflammatory response |
| 基金项目:国家自然科学基金(81471842，81671888，81772043);天津市自然科学基金(17JCYBJC24800) |
|
| 摘要点击次数: 3083 |
| 全文下载次数: 857 |
| 中文摘要: |
目的 探讨高浓度氢气(67%)吸入对老年患者髋部骨折术后谵妄(POD)的影响。
方法 选择在椎管内麻醉下行髋部骨折手术的老年患者80例, 年龄≥70岁, ASA Ⅱ或Ⅲ级, 采用随机数字表法分为两组：氢气吸入组（H组）和对照组（C组），每组40例。H组患者在麻醉前和手术结束后即刻分别给予含67%氢气和33%氧气的混合气体吸入60 min, C组患者给予33%氧气吸入。于氢气吸入前、吸入30 min和吸入60 min测定患者动脉血气。于氢气吸入前(T1)、术后即刻(T2)、术后3 h(T3)和术后6 h(T4)采集患者动脉血, 测定白细胞介素-6(IL-6)浓度和超氧化物歧化酶(SOD)活性。采用意识错乱评估法(CAM)评定术后7 d POD的发生情况。
结果 与T1时比较, T3和T4时两组患者IL-6浓度明显升高, SOD活性明显减弱(P<0.05);与C组比较, T2-T4时H组患者IL-6浓度明显降低, SOD活性明显增强(P<0.05)。C组患者POD发生12例(30%), 明显多于H组的3例(7.5%)(P<0.05)。两组血气分析差异无统计学意义。
结论 氢氧2∶1吸入明显降低老年患者髋部骨折POD的发生率, 其机制可能与调控炎症反应和氧化应激反应有关。 |
| 英文摘要: |
Objective To investigate the effect of high concentration of hydrogen gas inhalation on postoperative delirium (POD) in elderly patients receiving hip fracture surgery and its mechanism.
Methods Eighty elderly patients (both sexes, aged 70 years or higer, of ASA physical status Ⅱ or Ⅲ) undergoing elective hip fracture surgery were randomly divided into 2 groups (n=40 in each group): control group (group C) and hydrogen inhalation group (group H). The patients in group H were immediately given with the mixed gas containing 66.6% hydrogen and 33.3% oxygen inhalation for 60 min before anesthesia and immediately after surgery, while the patients in group C were given 33.3% oxygen inhalation. The arterial blood gas was respectively measured before hydrogen gas inhalation and at 30 min and 60 min after hydrogen gas inhalation in patients. Arterial blood samples were collected before hydrogen inhalation (T1), immediately after surgery (T2), postoperative 3 h (T3), postoperative 6 h (T4) to detect the levels of interleukin 6 (IL-6) and superoxide dismutase (SOD) in patients. POD was assessed by using the Confusion Assessment Method (CAM) during postoperative 7 days.
Results The incidence of POD in group H was significantly lower than that in group C (7.5% vs. 30.0%) (P < 0.05). Compared with that at T1, the level of IL-6 in both groups at T3 and T4 increased significantly, while the level of SOD activity decreased obviously (P < 0.05). Compared with that in group C, the IL-6 level of group H patients at T2-T4 was obviously reduced, while the SOD activity significantly increased (P < 0.05). High concentration of hydrogen inhalation did not affect the oxygenation function of patients between two groups.
Conclusion High concentration of hydrogen inhalation can significantly reduce the incidence of POD in elderly patients with hip fracture surgery, which may be associated with the regulation of inflammation and oxidative stress. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
