氟比洛芬酯对骨科老年男性病人术后早期认知功能的影响

目的研究氟比洛芬酯对骨科老年男性病人术后早期认知功能的影响。方法选择ASAI～Ⅱ级，60—75岁择期全麻下手术的骨科男性患者60例，体重45—75kg，体重指数正常。无高血压病史，肝、肾功能未见异常。无神经系统疾病及精神疾病病史，无严重视觉及听觉功能障碍，随机分为两组，每组30例。排除消化道溃疡、哮喘、正使用喹诺酮类药物者。A组：麻醉诱导后静注氟比洛芬酯50mg，B组：麻醉诱导后静注脂肪乳5mL。麻醉诱导采用咪达唑仑、舒芬太尼、罗库溴铵、丙泊酚静注，气管插管后接麻醉机行机械通气。麻醉维持采用持续泵注丙泊酚，吸入七氟烷。术中应用多功能监测仪连续监测血压、心率、心电图、脉搏血氧饱和度。记录术前及术后3hMMSE评分。结果两组老年男性病人术后POCD发生率分别为30％和33％，术前及术后MMSE评分组内比较有统计学意义（P〈0．05）。但术前及术后MMSE评分组间比较无统计学差异。结论氟比洛芬酯应用于骨科老年男性病人，不增加术后早期认知功能障碍的风险。

The Effect of Flurbiprofen Axetil for Earlier Period POCD in Orthopedics Older Male Patients

Objective To observe the prophylaxic antiemetic effect of Flurbiprofen axetil,the new drug in POCD patients of dissimilarity gender. Methods 60 ASA I - Ⅱ orthopedics male patients aged 60-75ys under general anesthesia were enrolled in this study.Body weights were normal.The patients were eliminated for diagnosed digestive canal and asthma.The patients were randomly assigned to two study groups：Group A received flurbiprofen axetil 50mg IV, Group B received fat milk 5mL IV.Anesthesia was induced with midazolam,sufentanyl, rocuronium,propofol,and maintained with inhalate sevoflurane and intravenous propofol.The MMSE scores were observed for the preoperative and postoperative 3h. Results The incidences of POCD were 30% and 33% for older male patients among Group A and B,there is difference of statistics for the MMSE scores between the preoperative and postoperative （P〈0.05）.There is no difference with the preoperative and postoperative between two groups（P〉0.05）. Conclusion Flurbiprofen axetil was utilized safely for orthopedics older male patients that it did not raise the risk of earlier neriod POCD.