文章摘要
古茹,骆卫玲,王嘉龙,等.术后延长吸氧时间对老年全膝关节置换术病人术后疼痛、炎症因子及免疫功能的影响.骨科,2024,15(3): 263-267.
术后延长吸氧时间对老年全膝关节置换术病人术后疼痛、炎症因子及免疫功能的影响
Effects of Prolonged Oxygen Inhalation Time after Surgery on Postoperative Pain, Inflammatory factors, and Immune Function in Elderly Patients Undergoing Total Knee Arthroplasty
投稿时间:2023-06-11  
DOI:10.3969/j.issn.1674-8573.2024.03.013
中文关键词: 术后延长吸氧  老年  全膝关节置换术  炎症因子  免疫功能
英文关键词: Postoperative prolonged oxygen inhalation  Elderly  Total knee arthroplasty  Inflammatory factors  Immune function
基金项目:
作者单位E-mail
古茹 西安交通大学第二附属医院麻醉手术科西安 710004  
骆卫玲 西安交通大学第二附属医院麻醉手术科西安 710004  
王嘉龙 西安交通大学第二附属医院麻醉手术科西安 710004  
李娜 西安交通大学第二附属医院麻醉手术科西安 710004  
常旺军 西安交通大学第二附属医院麻醉手术科西安 710004  
杨欢欢 西安交通大学第二附属医院麻醉手术科西安 710004  
王文 西安交通大学第二附属医院麻醉手术科西安 710004  
陈梦莎 西安交通大学第二附属医院麻醉手术科西安 710004  
吴莉娜 西安交通大学第二附属医院麻醉手术科西安 710004  
刘博 西安交通大学附属红会医院手术麻醉一科西安 710054  
陈晓丽 西安交通大学附属红会医院手术麻醉一科西安 710054  
李水霞 西安交通大学附属红会医院手术麻醉一科西安 710054 30444280@qq.com 
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中文摘要:
      目的 探讨术后延长吸氧时间对老年全膝关节置换术(TKA)病人术后疼痛、炎症因子及免疫功能的影响。方法 选取2022年1月至2023年1月西安交通大学第二附属医院收治的拟行TKA治疗的病人142例,男65例,女77例;年龄(73.35±7.30)岁。采用随机数字表法将病人分为观察组和对照组,每组71例。对照组病人术后给予8 h的常规鼻导管低流量(3 L/min)吸氧,观察组在对照组的基础上延长吸氧时间至术后48 h。观察两组术前和术后8、24、48 h简易精神状态检查量表(MMSE)评分和疼痛视觉模拟量表(VAS)评分,术前和术后8、48 h血清炎症因子和免疫功能指标水平;术前和术后24、48 h脉搏血氧饱和度(SpO2)、心率和呼吸频率情况。结果 观察组术后24、48 h MMSE评分显著高于对照组(P<0.05),VAS评分显著低于对照组(P<0.05)。两组术后24、48 h VAS评分较术前均显著降低(P<0.05)。对照组术后各时点MMSE评分较术前均显著降低(P<0.05),观察组术后8、24 h MMSE评分显著降低(P<0.05)。观察组术后24、48 h SpO2显著高于对照组(P<0.05),心率、呼吸频率显著低于对照组(P<0.05)。观察组术后48 h白介素-10(IL-10)、CD3+、CD4+、CD8+、CD4+/CD8+水平显著高于对照组(P<0.05),白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平显著低于对照组(P<0.05)。与术前比较,两组术后8、48 h血清IL-6、TNF-α水平均显著升高(P<0.05),CD3+、CD4+、CD8+、CD4+/CD8+水平均显著降低(P<0.05)。结论 术后延长吸氧时间可降低老年TKA病人疼痛,提高病人术后免疫功能,改善炎症因子水平。
英文摘要:
      Objective To explore the effects of prolonged oxygen inhalation time after surgery on postoperative pain, inflammatory factors, and immune function in elderly patients undergoing total knee arthroplasty (TKA). Methods A total of 142 patients planned to undergo TKA treatment admitted to the Second Affiliated Hospital of Xi'an Jiaotong University from January 2022 to January 2023 were selected, including 65 males and 77 females with an age range of (73.35±7.30) years. The random number table method was adopted to divide the observation group and the control group, with 71 cases in each group. The control group was given low-flow rate of conventional nasal catheter oxygen inhalation (3 L/min) for 8 h, and the observation group extended the oxygen inhalation time to 48 h after surgery. The Mini-mental State Examination (MMSE) score, Visual Analogue Scale (VAS), SpO2, heart rate, respiratory rate, serum inflammatory factors and immune function indicators were observed. Results The MMSE of the observation group was significantly higher than that of the control group at 24 and 48 h after surgery (P<0.05), and the VAS score was significantly lower than that of the control group (P<0.05). The VAS scores at 24 and 48 h after surgery in both groups were significantly lower than those before surgery (P<0.05). The MMSE score of the control group significantly decreased at all time points after surgery compared to that before surgery (P<0.05), while the MMSE score of the observation group significantly decreased at 8 and 24 h after surgery (P<0.05). The SpO2 of the observation group was significantly higher than that of the control group at 24 and 48 h after surgery (P<0.05), while the heart rate and respiratory rate were significantly lower than those of the control group (P<0.05). The levels of IL-10, CD3+、CD4+、CD8+、CD4+/CD8+ in the observation group were significantly higher than those in the control group 48 h after surgery (P<0.05), and the levels of IL-6 and TNF-α were significantly lower than those in the control group (P<0.05). Compared with preoperative levels, the serum levels of IL-6 and TNF-α in the two groups at 8 and 48 h postoperatively were significantly increased (P<0.05), and the levels of CD3+、CD4+、CD8+、CD4+/CD8+ were significantly decreased (P<0.05). Conclusion Prolonged postoperative oxygen inhalation time can reduce pain in elderly patients undergoing TKA, improve their postoperative immune function, and improve levels of inflammatory factors.
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