老年膝关节置换术患者应用帕瑞昔布钠术后早期认知功能的临床分析

目的：探讨在老年膝关节置换术中应用帕瑞昔布钠对术后早期认知功能的影响。方法选取该院在2010年1月-2013年1月择期行膝关节置换术治疗的老年患者60例，将所有患者随机分为观察组和对照组，观察组在麻醉诱导前和术后12 h分别给予40 mg帕瑞昔布钠的应用，对照组给予等量0.9%氯化钠溶液的应用，对两组患者的IL-6和TNF-α以及POCD发生率进行比较。结果两组患者术后IL-6和TNF-α浓度均明显升高，与麻醉诱导前比较（P〈0.05），而观察组IL-6的升高水平明显小于对照组（P〈0.05）；POCD发生率的比较，两组差异无统计学意义（P〉0.05）。结论在老年膝关节置换术中给予帕瑞昔布钠的应用可明显降低患者术后早期炎症因子的释放，但并未降低术后POCD的发生率。

The Clinical Analysis of the Postoperative Early Cognitive Function of El-derly Patients Using Celebrex Sodium in Knee Arthroplasty

Objective To investigate the effect of parecoxib sodium applied to elderly knee arthroplasty on the postoperative early cognitive function of the patients. Methods 60 elderly patients underwent selective knee arthroplasty in our hospital from January 2010 to January 2013 were selected and randomly divided into the observation group and the control group. The observation group were given parecoxib sodium 40mg before the induction of anesthesia and 12h after the operation, respectively, while the control group were given commensurable 0.9% sodium chloride solution. The IL-6, TNF-α and incidence of POCD of two groups of pa-tients were compared. Results After the operation, the IL-6 and TNF-α levels of both groups of patients were significantly in-creased, compared with those before the induction of anesthesia, P〈0.05, the elevated level of the observation group was signifi-cantly less than that of the control group, P〈0.05; there was no significant difference between the two groups in the incidence of POCD, P〉0.05. Conclusion The application of parecoxib sodium in elderly knee arthroplasty can significantly reduce the release of early inflammatory cytokines in patients after surgery, but it does not reduce the incidence of postoperative POCD.