| 李 罡,冯 晨,郑科文,李 静,王子健,金莲锦.乌司他丁对老年髋部骨折患者术后谵妄的预防作用[J].中国烧伤创疡杂志,2018,(6):413~417. |
| DOI： |
| 中文关键词: 乌司他丁 老年 髋部骨折 谵妄 影响 预防 |
| 英文关键词:Ulinastatin Elderly Hip fracture Delirium Influence Prevention |
| 基金项目:牡丹江市科学技术计划项目(Z2017s0061, Z2017s0038) |
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| 中文摘要: |
| 【摘要】 目的 探讨乌司他丁对老年髋部骨折患者术后谵妄的预防作用。方法 按照随机数字表法将2016年2 月—2018 年2 月牡丹江医学院附属红旗医院骨科收治的90 例老年髋部骨折患者随机分为观察组(45 例) 与对照组(45 例), 其中观察组患者分别于骨折内固定术切皮前及术后第1、2 天在10 min 内静脉泵入5000 U/kg乌司他丁+50 mL生理盐水, 对照组患者分别于骨折内固定术切皮前及术后第1、2 天在10 min 内静脉泵入等量生理盐水。对比两组患者的Ramsay 镇静评分、S100β 蛋白水平、术后谵妄发病率、手术时间、术中出血量及不良反应发生率。结果 术后观察组患者Ramsay 镇静评分为(1.88±0.12) 分、S100β 蛋白水平为(0.75±0.15)μg/ L、谵妄发病率为4.44%, 对照组患者Ramsay 镇静评分为(1.23±0.12)分、S100β 蛋白水平为(1.31±0.31)μg/ L、谵妄发病率为22.22%, 两组患者Ramsay 镇静评分、S100β 蛋白水平及谵妄发生情况对比, P 均<0.05, 差异具有统计学意义; 观察组患者的手术时间为(114.11±21.41) min、术中出血量为(324.13±11.24) mL、不良反应发生率为6.67%, 对照组患者的手术时间为(114.42±21.25)min、术中出血量为(324.23±11.51)mL、不良反应发生率为4.44%, 两组患者手术时间、术中出血量及不良反应发生情况对比, P 均>0.05, 差异无统计学意义。结论 乌司他丁可有效降低老年髋部骨折患者术后谵妄的发病率, 保护患者的认知功能, 进而提高治疗效果, 疗效显著, 且安全性较高, 值得临床推广应用。 |
| 英文摘要: |
| 【Abstract】 Objective To investigate the preventive effect of Ulinastatin on postoperative delirium in elderly patientswith hip fracture. Methods A total of 90 elderly patients with hip fracture, admitted into the Department of Orthopedics,Hongqi Hospital Affiliated to Mudanjiang Medical University from February 2016 to February 2018, were randomly divided into observation group (45 cases) and control group (45 cases). The patients in the observation group were given intravenous pumping of 5000 U/kg Ulinastatin +50 mL normal saline within 10 min respectively before the skin incision of the internal fracture fixation, and day 1 and day 2 after the operation, while the patients in the control group were simply given intravenous pumping of the same volume of normal saline within 10 minutes respectively before the skin incision of the internal fracture fixation, and day 1 and day 2 after the operation. Ramsay sedation score, S100β protein level, postoperative delirium incidence, operation duration, intraoperative blood loss volume and incidence of adverse reactions were compared between the two groups. Results After the operation in the observation group, the Ramsay sedation score was (1.88±0.12) points, the S100β protein level was (0.75±0.15) μg/ L and the delirium incidence was 4.44%, and as compared sequentially with (1.23±0.12) points, (1.31±0.31) μg/ L and 22.22% in the control group, statistically significant differences were observed (all P <0.05). In the observation group, the operation duration was (114.11±21.41) min, the intraoperative blood loss volume was (324.13 ±11.24) mL and the incidence of adverse reactions was 6.67%, and no statistically significant difference was observed as compared with (114.42±21.25) min, (324.23±11.51) mL and 4. 44% in the control group (all P >0.05). Conclusion Ulinastatin can effectively reduce the incidence of postoperative delirium in elderly patients with hip fracture, protect their cognitive function, and thus improve the therapeutic effect. It deserves to be promoted in clinical practice due to its high safety and good curative effect. |
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