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目的:观察帕瑞昔布钠超前镇痛对军人术后认知功能障碍(POCD)的影响。方法:选择择期行下腹部手术军人60例,随机分为观察组和对照组各30例。全麻诱导前,观察组静脉注射帕瑞昔布钠40mg,对照组给予等容量生理盐水。两组分别于术前1天和术后1天,采用神经心理学量表中的数字广度测验、数字符号测验、Stroop测验、中文听觉词汇学习测验测评认知功能。采用Z计分法判断两组术后POCD发生情况。结果:观察组术后静脉自控镇痛芬太尼用量(550±50)μg,显著低于对照组的(700±100)μg(P<0.05);芬太尼补救用药率10%,显著低于对照组的40%(P<0.05);POCD发生率6.6%,显著低于对照组的26.6%(P<0.05)。结论:帕瑞昔布钠超前镇痛可降低军人术后POCD的发生率,可能与增强术后镇痛效果有关。
Objective: To observe the effect of parecoxib sodium on postoperative cognitive dysfunction (POCD) in soldiers. Methods: Sixty patients undergoing elective abdominal surgery were randomly divided into observation group (30 cases) and control group (30 cases). Before induction of general anesthesia, the observation group intravenous injection of parecoxib sodium 40mg, the control group given equal volume of saline. The two groups were respectively evaluated on cognitive function by digital breadth test, digital sign test, Stroop test and Chinese auditory vocabulary test on the neuropsychological scale one day before operation and one day after operation. Z score was used to determine the incidence of postoperative POCD. Results: The postoperative intravenous controlled-use analgesia of fentanyl (550 ± 50) μg was significantly lower than that of the control group (700 ± 100 μg) (P <0.05). The fentanyl remission rate was 10% (P <0.05). The incidence of POCD was 6.6%, which was significantly lower than that of the control group (26.6%, P <0.05). Conclusion: Parecoxib sodium preemptive analgesia can reduce the incidence of postoperative POCD in military service, which may be related to the enhancement of postoperative analgesia.