首页 期刊 论文 学科刊群 资讯 加盟 关于
EN
image
Article(id=1241720040723107990, tenantId=1146029695717560320, journalId=1205117082300743687, issueId=1241720034091914228, articleNumber=null, orderNo=null, doi=10.14109/j.cnki.xyylc.2024.06.11, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1681920000000, receivedDateStr=2023-04-20, revisedDate=null, revisedDateStr=null, acceptedDate=1709049600000, acceptedDateStr=2024-02-28, onlineDate=1773978727750, onlineDateStr=2026-03-20, pubDate=1719244800000, pubDateStr=2024-06-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773978727750, onlineIssueDateStr=2026-03-20, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773978727750, creator=13701087609, updateTime=1773978727750, updator=13701087609, issue=Issue{id=1241720034091914228, tenantId=1146029695717560320, journalId=1205117082300743687, year='2024', volume='43', issue='6', pageStart='401', pageEnd='480', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773978726169, creator=13701087609, updateTime=1773979021315, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241721272128828343, tenantId=1146029695717560320, journalId=1205117082300743687, issueId=1241720034091914228, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241721272128828344, tenantId=1146029695717560320, journalId=1205117082300743687, issueId=1241720034091914228, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=450, endPage=454, ext={EN=ArticleExt(id=1241720042405023917, articleId=1241720040723107990, tenantId=1146029695717560320, journalId=1205117082300743687, language=EN, title=Effects of flurbiprofen combined with quadratus lumborum block on postoperative neurocognitive function and inflammatory response in elderly patients with nephrectomy under general anesthesia, columnId=1207314218647392369, journalTitle=Chinese Journal of New Drugs and Clinical Remedies, columnName=Original Article, runingTitle=null, highlight=null, articleAbstract=
AIM

To evaluate the effects of flurbiprofen combined with quadratus lumborum block (QLB) on postoperative neurocognitive function and inflammatory response in elderly patients undergoing nephrectomy.

METHODS

Sixty elderly patients undergoing laparoscopic nephrectomy were randomized into group Q (QLB group) and group FQ (flurbiprofen combined with QLB group), 30 patients in each group. Ultrasound guided anterior QLB were performed in all patients on the surgical side. Patients in group FQ received flurbiprofen 1 mg·kg-1 iv 10 min before surgery. Then both groups received general anesthesia. The dosages of propofol and remifentanil during surgery and the effective number of analgesia pump presses were recorded. The scores of visual analogue scale (VAS) and Bruggrmann comfort scale (BCS) were evaluated at 6, 24, 48 h after surgery. The neurocognitive function was evaluated at 1 d before surgery and 1 d and 7 d after surgery using the mini-mental state examination (MMSE), and the incidence of postoperative neurocognitive disorder (PND) within 7 d after surgery was recorded. Venous blood was collected and the serum levels of high mobility group box protein 1 (HMGB1) and interleukin 6 (IL-6) were tested 1 h before surgery and 30 min and 24 h after the surgery.

RESULTS

Compared with group Q, the dosage of remifentanil was significantly reduced in group FQ (P<0.05), and the effective numbers of analgesia pump presses were reduced in group FQ (P<0.05). At 6, 24 h after surgery, the VAS score was lower, and the BCS score was higher in group FQ than group Q (P<0.05). Compared with group Q, the MMSE score at 1, 7 d after surgery was significantly higher in the group FQ (P<0.05), the incidence of PND within 7 d after surgery was lower in group FQ (P<0.05). The HMGB1 and IL-6 levels at 30 min, 24 h after the surgery were significantly lower in group FQ than group Q (P<0.05).

CONCLUSION

Flurbiprofen combined with QLB can reduce the incidence of PND in elderly patients undergoing nephrectomy, which may be related to the perfect early postoperative analgesia and the decreased levels of inflammatory cytokines.

, correspAuthors=null, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, authorCompany=null, fund=null, authors=null, authorsList=Man-hua ZHU, Qi-lu YING, Ling-zhi WANG, Rui-fen ZHOU), CN=ArticleExt(id=1241720043113861342, articleId=1241720040723107990, tenantId=1146029695717560320, journalId=1205117082300743687, language=CN, title=氟比洛芬联合腰方肌阻滞对老年患者全身麻醉肾切除术后神经认知功能及炎症反应的影响, columnId=1207314219226206329, journalTitle=中国新药与临床杂志, columnName=论著, runingTitle=null, highlight=null, articleAbstract=
目的

评价氟比洛芬复合腰方肌阻滞对老年患者肾切除术后神经认知功能及炎症反应的影响。

方法

选择择期行腹腔镜肾切除术的老年患者60例，随机分为Q组（腰方肌阻滞组）和FQ组（氟比洛芬联合腰方肌阻滞组），每组30例。麻醉诱导前30 min，2组患者均予以超声引导下手术侧前路腰方肌阻滞。FQ组患者术前10 min静脉注射氟比洛芬1 mg·kg-1，随后2组患者均予以全身麻醉。记录术中丙泊酚、瑞芬太尼用量，术后24 h镇痛泵有效按压次数，评估术后6、24、48 h疼痛视觉模拟量表（VAS）评分及Bruggrmann舒适度量表（BCS）评分。于术前1 d和术后1、7 d采用简易精神状态检查（MMSE）评估患者的神经认知情况，并记录术后7 d内患者术后神经认知障碍（PND）的发生率。检测术前1 h和术后30 min、24 h血高迁移率族蛋白B 1（HMGB1）、白细胞介素（IL）-6的水平。

结果

与Q组相比，FQ组术中瑞芬太尼用量显著减少（P<0.05），术后24 h镇痛泵有效按压次数显著减少（P<0.05）。术后6、24 h，FQ组VAS评分显著低于Q组（P<0.05），BCS评分显著高于Q组（P<0.05）。术后1、7 d，FQ组MMSE评分显著高于Q组（P<0.05）；术后7 d内FQ组PND的发生率显著低于Q组（7% vs. 27%，P<0.05）。术后30 min、24 h，FQ组HMGB1、IL-6水平均显著低于Q组（P<0.05）。2组术后不良反应发生率无显著差异（P>0.05）。

结论

氟比洛芬联合腰方肌阻滞可降低肾切除术老年患者PND的发生率，可能与术后早期完善的镇痛效果及炎症因子水平降低有关。

, correspAuthors=null, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=《中国新药与临床杂志》编辑部, extLink=null, articleAbsUrl=null, sourceXml=eYCH6i9sCOyeta0soetQfw==, magXml=AzCRW4VwJ9GCHEECQAe8jw==, pdfUrl=null, pdf=BOjhu29r6hjYEUEOdfdtcQ==, pdfFileSize=1804403, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=3pehW3xMsuDTmxIukW5Ziw==, mapNumber=null, authorCompany=null, fund=null, authors=

朱曼华，女，副主任医师，硕士，主要从事围术期神经认知障碍方面的研究，E-mail：

, authorsList=朱曼华, 应骐潞, 王玲志, 周瑞芬)}, authors=[Author(id=1241720043394879726, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, orderNo=0, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=jszhumanhua@163.com, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1241720043503931638, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, authorId=1241720043394879726, language=EN, stringName=Man-hua ZHU, firstName=Man-hua, middleName=null, lastName=ZHU, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=Department of Anesthesiology, the Affiliated Lihuili Hospital of Ningbo University, Ningbo ZHEJIANG 315040, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1241720043604594940, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, authorId=1241720043394879726, language=CN, stringName=朱曼华, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=宁波大学附属李惠利医院 麻醉科，浙江 宁波　315040, bio={"content":"

朱曼华，女，副主任医师，硕士，主要从事围术期神经认知障碍方面的研究，E-mail：

"}, bioImg=null, bioContent=

朱曼华，女，副主任医师，硕士，主要从事围术期神经认知障碍方面的研究，E-mail：

, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1241720043302605032, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, xref=null, ext=[AuthorCompanyExt(id=1241720043310993642, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, companyId=1241720043302605032, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Anesthesiology, the Affiliated Lihuili Hospital of Ningbo University, Ningbo ZHEJIANG 315040, China), AuthorCompanyExt(id=1241720043315187948, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, companyId=1241720043302605032, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=宁波大学附属李惠利医院 麻醉科，浙江 宁波　315040)])]), Author(id=1241720043705258242, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, orderNo=1, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1241720043797532936, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, authorId=1241720043705258242, language=EN, stringName=Qi-lu YING, firstName=Qi-lu, middleName=null, lastName=YING, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=Department of Anesthesiology, the Affiliated Lihuili Hospital of Ningbo University, Ningbo ZHEJIANG 315040, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1241720043894001934, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, authorId=1241720043705258242, language=CN, stringName=应骐潞, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=宁波大学附属李惠利医院 麻醉科，浙江 宁波　315040, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1241720043302605032, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, xref=null, ext=[AuthorCompanyExt(id=1241720043310993642, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, companyId=1241720043302605032, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Anesthesiology, the Affiliated Lihuili Hospital of Ningbo University, Ningbo ZHEJIANG 315040, China), AuthorCompanyExt(id=1241720043315187948, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, companyId=1241720043302605032, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=宁波大学附属李惠利医院 麻醉科，浙江 宁波　315040)])]), Author(id=1241720044011442452, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, orderNo=2, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1241720044099522842, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, authorId=1241720044011442452, language=EN, stringName=Ling-zhi WANG, firstName=Ling-zhi, middleName=null, lastName=WANG, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=Department of Anesthesiology, the Affiliated Lihuili Hospital of Ningbo University, Ningbo ZHEJIANG 315040, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1241720044187603231, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, authorId=1241720044011442452, language=CN, stringName=王玲志, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=宁波大学附属李惠利医院 麻醉科，浙江 宁波　315040, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1241720043302605032, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, xref=null, ext=[AuthorCompanyExt(id=1241720043310993642, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, companyId=1241720043302605032, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Anesthesiology, the Affiliated Lihuili Hospital of Ningbo University, Ningbo ZHEJIANG 315040, China), AuthorCompanyExt(id=1241720043315187948, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, companyId=1241720043302605032, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=宁波大学附属李惠利医院 麻醉科，浙江 宁波　315040)])]), Author(id=1241720044288266532, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, orderNo=3, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1241720044401512745, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, authorId=1241720044288266532, language=EN, stringName=Rui-fen ZHOU, firstName=Rui-fen, middleName=null, lastName=ZHOU, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=Department of Anesthesiology, the Affiliated Lihuili Hospital of Ningbo University, Ningbo ZHEJIANG 315040, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1241720044464427311, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, authorId=1241720044288266532, language=CN, stringName=周瑞芬, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=宁波大学附属李惠利医院 麻醉科，浙江 宁波　315040, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1241720043302605032, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, xref=null, ext=[AuthorCompanyExt(id=1241720043310993642, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, companyId=1241720043302605032, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Anesthesiology, the Affiliated Lihuili Hospital of Ningbo University, Ningbo ZHEJIANG 315040, China), AuthorCompanyExt(id=1241720043315187948, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, companyId=1241720043302605032, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=宁波大学附属李惠利医院 麻醉科，浙江 宁波　315040)])])], keywords=[Keyword(id=1241720044586062133, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, language=EN, orderNo=1, keyword=flurbiprofen), Keyword(id=1241720044674142522, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, language=EN, orderNo=2, keyword=aged), Keyword(id=1241720044804165947, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, language=EN, orderNo=3, keyword=nephrectomy), Keyword(id=1241720044900634944, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, language=EN, orderNo=4, keyword=laparoscopes), Keyword(id=1241720044984521027, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, language=EN, orderNo=5, keyword=neurocognitive disorders), Keyword(id=1241720045060018502, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, language=EN, orderNo=6, keyword=quadratus lumborum block), Keyword(id=1241720045143904584, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, language=EN, orderNo=7, keyword=inflammatory response), Keyword(id=1241720046628688202, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, language=CN, orderNo=1, keyword=氟比洛芬), Keyword(id=1241720046712574286, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, language=CN, orderNo=2, keyword=老年人), Keyword(id=1241720046796460366, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, language=CN, orderNo=3, keyword=肾切除术), Keyword(id=1241720046859374929, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, language=CN, orderNo=4, keyword=腹腔镜), Keyword(id=1241720046943261012, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, language=CN, orderNo=5, keyword=神经认知障碍), Keyword(id=1241720047022952791, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, language=CN, orderNo=6, keyword=腰方肌阻滞), Keyword(id=1241720047102644571, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, language=CN, orderNo=7, keyword=炎症反应)], refs=[Reference(id=1241720047882785139, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, doi=null, pmid=null, pmcid=null, year=2018, volume=19, issue=1, pageStart=1, pageEnd=8, url=null, language=null, rfNumber=[1], rfOrder=0, authorNames=NASRALLAH G, SOUKI FG, journalName=Curr Urol Rep, refType=null, unstructuredReference=NASRALLAH G，SOUKI FG. Perianesthetic management of laparoscopic kidney surgery [J]. Curr Urol Rep, 2018, 19 （1）:1-8., articleTitle=Perianesthetic management of laparoscopic kidney surgery, refAbstract=null), Reference(id=1241720047949894007, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, doi=null, pmid=null, pmcid=null, year=2018, volume=129, issue=5, pageStart=872, pageEnd=879, url=null, language=null, rfNumber=[2], rfOrder=1, authorNames=EVERED L, SILBERT B, KNOPMAN DS, journalName=Anesthesiology, refType=null, unstructuredReference=EVERED L, SILBERT B, KNOPMAN DS, et al. Recommendations for the nomenclature of cognitive change associated with anaesthesia and surgery-2018[J]. Anesthesiology, 2018, 129 （5）: 872-879., articleTitle=Recommendations for the nomenclature of cognitive change associated with anaesthesia and surgery-2018, refAbstract=null), Reference(id=1241720048017002874, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, doi=null, pmid=null, pmcid=null, year=2019, volume=19, issue=1, pageStart=154, pageEnd=null, url=null, language=null, rfNumber=[3], rfOrder=2, authorNames=ZHU MH, QI Y, HE HJ, journalName=BMC Anesthesiol, refType=null, unstructuredReference=ZHU MH, QI Y, HE HJ, et al. Analgesic effect of the ultrasound-guided subcostal approach to transmuscular quadratus lumborum block in patients undergoing laparoscopic nephrectomy: a randomized controlled trial[J]. BMC Anesthesiol, 2019, 19（1）:154., articleTitle=Analgesic effect of the ultrasound-guided subcostal approach to transmuscular quadratus lumborum block in patients undergoing laparoscopic nephrectomy: a randomized controlled trial, refAbstract=null), Reference(id=1241720048096694651, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, doi=null, pmid=null, pmcid=null, year=2018, volume=38, issue=4, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[4], rfOrder=3, authorNames=WU H, TANG C, TAI LW, journalName=Biosci Rep, refType=null, unstructuredReference=WU H, TANG C, TAI LW, et al. Flurbiprofen axetil attenuates cerebral ischemia/ reperfusion injury by reducing inflammation in a rat model of transient global cerebral ischemia / reperfusion[J].Biosci Rep, 2018, 38 （4）: BSR20171562., articleTitle=Flurbiprofen axetil attenuates cerebral ischemia/ reperfusion injury by reducing inflammation in a rat model of transient global cerebral ischemia / reperfusion, refAbstract=null), Reference(id=1241720048159609212, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, doi=null, pmid=null, pmcid=null, year=2019, volume=35, issue=10, pageStart=1026, pageEnd=1029, url=null, language=null, rfNumber=[5], rfOrder=4, authorNames=段振馨, 段光友, 李 洪, journalName=临床麻醉学杂志, refType=null, unstructuredReference=段振馨, 段光友, 李 洪. 围术期神经认知障碍诊断方法、流程及注意事项的研究进展 [J]. 临床麻醉学杂志, 2019, 35（10）: 1026-1029., articleTitle=围术期神经认知障碍诊断方法、流程及注意事项的研究进展, refAbstract=null), Reference(id=1241720048226718079, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, doi=null, pmid=null, pmcid=null, year=2021, volume=37, issue=5, pageStart=542, pageEnd=545, url=null, language=null, rfNumber=[6], rfOrder=5, authorNames=赵雨帆, 欧阳文, 胡中华, journalName=临床麻醉学杂志, refType=null, unstructuredReference=赵雨帆, 欧阳文, 胡中华, 等. 老年患者围术期神经认知障碍与术后急性疼痛的研究进展[J]. 临床麻醉学杂志, 2021, 37（5）: 542-545., articleTitle=老年患者围术期神经认知障碍与术后急性疼痛的研究进展, refAbstract=null), Reference(id=1241720048323187075, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, doi=null, pmid=null, pmcid=null, year=2018, volume=127, issue=2, pageStart=496, pageEnd=505, url=null, language=null, rfNumber=[7], rfOrder=6, authorNames=EVERED LA, SILBERT BS, journalName=Anesth Analg, refType=null, unstructuredReference=EVERED LA, SILBERT BS. Postoperative cognitive dysfunction and noncardiac surgery[J]. Anesth Analg, 2018, 127 （2）: 496-505., articleTitle=Postoperative cognitive dysfunction and noncardiac surgery, refAbstract=null), Reference(id=1241720048444821893, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, doi=null, pmid=null, pmcid=null, year=2020, volume=163, issue=4, pageStart=835, pageEnd=842, url=null, language=null, rfNumber=[8], rfOrder=7, authorNames=GOLLAPUDY S, GASHKOFF DA, POETKER DM, journalName=Otolaryngol Head Neck Surg, refType=null, unstructuredReference=GOLLAPUDY S, GASHKOFF DA, POETKER DM, et al. Surgical field visualization during functional endoscopic sinus surgery:comparison of propofol- vs desflurane-based anesthesia[J].Otolaryngol Head Neck Surg, 2020, 163 （4）: 835-842., articleTitle=Surgical field visualization during functional endoscopic sinus surgery:comparison of propofol- vs desflurane-based anesthesia, refAbstract=null), Reference(id=1241720048520319368, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, doi=null, pmid=null, pmcid=null, year=2019, volume=130, issue=2, pageStart=322, pageEnd=335, url=null, language=null, rfNumber=[9], rfOrder=8, authorNames=ELSHARKAWY H, EL-BOGHDADLY K, BARRINGTON M, journalName=Anesthesiology, refType=null, unstructuredReference=ELSHARKAWY H, EL-BOGHDADLY K, BARRINGTON M.Quadratus lumborum block: anatomical concepts, mechanisms, and techniques[J]. Anesthesiology, 2019, 130（2）: 322-335., articleTitle=Quadratus lumborum block: anatomical concepts, mechanisms, and techniques, refAbstract=null), Reference(id=1241720048600011144, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, doi=null, pmid=null, pmcid=null, year=2020, volume=36, issue=7, pageStart=638, pageEnd=642, url=null, language=null, rfNumber=[10], rfOrder=9, authorNames=战海燕, 周 琪, 张析哲, journalName=临床麻醉学杂志, refType=null, unstructuredReference=战海燕, 周 琪, 张析哲, 等. 不同剂量氟比洛芬酯对老年全髋关节置换术患者术后神经认知功能的影响[J]. 临床麻醉学杂志, 2020, 36 （7）: 638-642., articleTitle=不同剂量氟比洛芬酯对老年全髋关节置换术患者术后神经认知功能的影响, refAbstract=null), Reference(id=1241720048667120010, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, doi=null, pmid=null, pmcid=null, year=2020, volume=36, issue=7, pageStart=638, pageEnd=642, url=null, language=null, rfNumber=[10], rfOrder=10, authorNames=ZHAN HY, ZHOU Q, ZHANG XZ, journalName=J Clin Anesthesiol, refType=null, unstructuredReference=ZHAN HY, ZHOU Q, ZHANG XZ, et al. Effects of different doses of flurbiprofen on neurocognitive function in elderly patients undergoing total hip arthroplasty[J].J Clin Anesthesiol, 2020, 36 （7）: 638-642., articleTitle=Effects of different doses of flurbiprofen on neurocognitive function in elderly patients undergoing total hip arthroplasty, refAbstract=null), Reference(id=1241720048742617484, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, doi=null, pmid=null, pmcid=null, year=2018, volume=76, issue=9, pageStart=1869, pageEnd=1872, url=null, language=null, rfNumber=[11], rfOrder=11, authorNames=YOSHIDA M, SHIMIZU Y, YOSHIDA K, journalName=J Oral Maxillofac Surg, refType=null, unstructuredReference=YOSHIDA M, SHIMIZU Y, YOSHIDA K, et al. Effective postoperative analgesia using intravenous flurbiprofen and acetaminophen [J]. J Oral Maxillofac Surg, 2018, 76 （9）: 1869-1872., articleTitle=Effective postoperative analgesia using intravenous flurbiprofen and acetaminophen, refAbstract=null), Reference(id=1241720048805532046, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, doi=null, pmid=null, pmcid=null, year=2020, volume=40, issue=2, pageStart=329, pageEnd=331, url=null, language=null, rfNumber=[12], rfOrder=12, authorNames=刘 彦, journalName=中国老年学杂志, refType=null, unstructuredReference=刘 彦. 麻醉深度对高龄患者全麻手术 POCD 的影响及其作用机制[J]. 中国老年学杂志, 2020, 40 （2）: 329-331., articleTitle=麻醉深度对高龄患者全麻手术 POCD 的影响及其作用机制, refAbstract=null), Reference(id=1241720048864252304, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, doi=null, pmid=null, pmcid=null, year=2021, volume=21, issue=1, pageStart=238, pageEnd=null, url=null, language=null, rfNumber=[13], rfOrder=13, authorNames=ZHU MH, QI Y, HE HJ, journalName=BMC Geriatr, refType=null, unstructuredReference=ZHU MH, QI Y, HE HJ, et al. Effect of quadratus lumborum block on postoperative cognitive function in elderly patients undergoing laparoscopic radical gastrectomy: a randomized controlled trial [J].BMC Geriatr, 2021, 21（1）: 238., articleTitle=Effect of quadratus lumborum block on postoperative cognitive function in elderly patients undergoing laparoscopic radical gastrectomy: a randomized controlled trial, refAbstract=null)], funds=[Fund(id=1241720047782121840, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, awardId=2020KY866, language=CN, fundingSource=浙江省医药卫生科技计划项目(2020KY866), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1241720043302605032, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, xref=null, ext=[AuthorCompanyExt(id=1241720043310993642, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, companyId=1241720043302605032, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Anesthesiology, the Affiliated Lihuili Hospital of Ningbo University, Ningbo ZHEJIANG 315040, China), AuthorCompanyExt(id=1241720043315187948, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, companyId=1241720043302605032, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=宁波大学附属李惠利医院 麻醉科，浙江 宁波　315040)])], figs=[ArticleFig(id=1241720047249445213, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
指标Q组FQ组
性别/例（%）
男16（53）17（57）
女14（47）13（43）
年龄/岁71.2±4.672.2±5.4
ASA分级/例（%）
Ⅱ25（83）24（80）
Ⅲ5（17）6（20）
体重指数/ kg·m-224.9±3.223.7±5.5
受教育年限/年7.9±2.27.8±1.8
), ArticleFig(id=1241720047337525600, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, language=CN, label=表1, caption=

一般资料组间比较

, figureFileSmall=null, figureFileBig=null, tableContent=
指标Q组FQ组
性别/例（%）
男16（53）17（57）
女14（47）13（43）
年龄/岁71.2±4.672.2±5.4
ASA分级/例（%）
Ⅱ25（83）24（80）
Ⅲ5（17）6（20）
体重指数/ kg·m-224.9±3.223.7±5.5
受教育年限/年7.9±2.27.8±1.8
), ArticleFig(id=1241720047413023075, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
指标Q组FQ组
麻醉时间/ min130.3±18.8124.7±20.3a
术中丙泊酚用量/ mg686.2±165.88676.7±148.5a
术中瑞芬太尼用量/ μg901.3±184.5716.7±177.1b
术后24 h内镇痛泵按压次数/次9.5（7, 12）7.0（5.2, 9.0）b
静息状态VAS评分术后6 h3.0（2.2, 4.0）2.0（1.0, 3.0）b
术后24 h2.0（2.0, 3.0）1.0（1.0, 2.0）b
术后48 h2.0（0.2, 2.0）1.0（0.2, 2.0）a
BCS评分术后6 h2.0（1.0, 2.0）2.0（2.0, 3.0）b
术后24 h2.0（1.0, 2.0）2.0（2.0, 3.0）b
术后48 h3.0（2.0, 3.0）3.0（2.0, 4.0）a
), ArticleFig(id=1241720047488520551, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, language=CN, label=表2, caption=

麻醉、术后镇痛及舒适度情况组间比较

, figureFileSmall=null, figureFileBig=null, tableContent=
指标Q组FQ组
麻醉时间/ min130.3±18.8124.7±20.3a
术中丙泊酚用量/ mg686.2±165.88676.7±148.5a
术中瑞芬太尼用量/ μg901.3±184.5716.7±177.1b
术后24 h内镇痛泵按压次数/次9.5（7, 12）7.0（5.2, 9.0）b
静息状态VAS评分术后6 h3.0（2.2, 4.0）2.0（1.0, 3.0）b
术后24 h2.0（2.0, 3.0）1.0（1.0, 2.0）b
术后48 h2.0（0.2, 2.0）1.0（0.2, 2.0）a
BCS评分术后6 h2.0（1.0, 2.0）2.0（2.0, 3.0）b
术后24 h2.0（1.0, 2.0）2.0（2.0, 3.0）b
术后48 h3.0（2.0, 3.0）3.0（2.0, 4.0）a
), ArticleFig(id=1241720047568212330, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
指标Q组FQ组
MMSE评分术前1 d27.4±1.827.3±2.1a
术后1 d23.7±2.825.8±3.2b
术后7 d25.1±2.526.6±2.3b
PND/例（%）8（27）2（7）b
HMGB1/ng·L-1术前1 h661.01±161.96654.86±187.30a
术后30 min866.50±138.94762.45±186.79b
术后24 h755.60±184.83697.41±144.65b
IL-6/ng·L-1术前1 h23.12±5.5521.21±5.23a
术后30 min31.81±5.4424.40±7.93b
术后24 h28.36±6.1223.13±7.29b
), ArticleFig(id=1241720047673069931, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1241720040723107990, language=CN, label=表3, caption=

认知功能及不同时点HMGB1、IL-6水平组间比较

, figureFileSmall=null, figureFileBig=null, tableContent=
指标Q组FQ组
MMSE评分术前1 d27.4±1.827.3±2.1a
术后1 d23.7±2.825.8±3.2b
术后7 d25.1±2.526.6±2.3b
PND/例（%）8（27）2（7）b
HMGB1/ng·L-1术前1 h661.01±161.96654.86±187.30a
术后30 min866.50±138.94762.45±186.79b
术后24 h755.60±184.83697.41±144.65b
IL-6/ng·L-1术前1 h23.12±5.5521.21±5.23a
术后30 min31.81±5.4424.40±7.93b
术后24 h28.36±6.1223.13±7.29b
)], attaches=null, journal=Journal(id=1205114437246812164, delFlag=0, nameCn=中国新药与临床杂志, nameEn=Chinese Journal of New Drugs and Clinical Remedies, nameHistory1=null, nameHistory2=null, issn=1007-7669, eissn=, cn=31-1746/R, coden=null, periodic=月刊, language=CN, oaType=1, ccby=null, superviseOffice=null, ownerOffice=null, pubOffice=null, editorOffice=null, officeType=null, aims=null, clcCode=null, officeProv=null, officeCity=null, officeAddr=null, officeZip=null, officeEmail=, officePhone=, editDirector=null, officeDirector=null, officeDirectorPhone=null, officeStaffNum=null, officeEmpNum=null, coverPicUrl=4CRZH/cEJmlFWJuWhAUDig==, journalPrice=null, startedYear=null, abbrevIsoEn=Chinese Journal of New Drugs and Clinical Remedies, journalRemark=null, publicationField=null, createdTime=1765251271787, updatedTime=1765252216403, createdBy=18614031015, updatedBy=13701087609, firstLetterCn=C, firstLetterEn=C, subjectCode=Life Sciences, subjectName=生命医学, subjectCodeEn=Life Sciences, subjectNameEn=null, picCn=4CRZH/cEJmlFWJuWhAUDig==, picEn=N3vp8/tZorUwVBJknBXdng==, jcr=null, cjcr=null, exts=[JournalExt(id=1205118399413203150, language=CN, name=中国新药与临床杂志, nameHistory1=null, nameHistory2=null, managedBy=, sponsoredBy=, publishedBy=, editorOffice=, officeProv=null, officeCity=null, officeAddr=, officeZip=, editDirector=, officeDirector=null, officePhone=null, coverPicUrl=null, journalRemark=, submitArticleUrl=null, websiteUrl=, createdTime=1765252216437, updatedTime=1765252216437, createdBy=13701087609, updatedBy=13701087609, submissionGuidelinesUrl=, submissionAuthorUrl=http://xyyl.cbpt.cnki.net/index.aspx?t=1, submissionEditorUrl=http://xyyl.cbpt.cnki.net/index.aspx?t=3, submissionReviewUrl=http://xyyl.cbpt.cnki.net/index.aspx?t=2, submissionCeEditorUrl=, submissionAeEditorUrl=, option={"copyright":""}), JournalExt(id=1205118399467729103, language=EN, name=Chinese Journal of New Drugs and Clinical Remedies, nameHistory1=null, nameHistory2=null, managedBy=, sponsoredBy=, publishedBy=, editorOffice=, officeProv=null, officeCity=null, officeAddr=, officeZip=, editDirector=, officeDirector=null, officePhone=null, coverPicUrl=null, journalRemark=, submitArticleUrl=null, websiteUrl=, createdTime=1765252216450, updatedTime=1765252216450, createdBy=13701087609, updatedBy=13701087609, submissionGuidelinesUrl=, submissionAuthorUrl=http://xyyl.cbpt.cnki.net/index.aspx?t=1, submissionEditorUrl=http://xyyl.cbpt.cnki.net/index.aspx?t=3, submissionReviewUrl=http://xyyl.cbpt.cnki.net/index.aspx?t=2, submissionCeEditorUrl=, submissionAeEditorUrl=, option={"copyright":""})], databaseList=null, tenantJournalId=1205117082300743687, websiteList=[Website(id=1205118568049389783, webName=null, webTitle=null, webDomain=null, webCopyrigh=null, webIpcNo=null, seoTitle=null, seoKeywords=null, seoDescription=null, tenantJournalId=null, journalId=1205117082300743687, journalNameCn=null, journalNameEn=null, grayFlag=null, tenantId=1146029695717560320, platformId=null, journalGroupId=null, journalGroupNameCn=null, journalGroupNameEn=null, type=1, domain=https://castjournals.cast.org.cn/joweb/zgxyylczz/CN, language=CN, createTime=1765252256643, createBy=18614031015, updateTime=1765252598399, updateBy=18614031015, name=中国新药与临床杂志-中文, tplId=1146099689490845704, title=中国新药与临床杂志, delFlag=0, indexPage=/home, props=[WebsiteProps(id=1205154564317098673, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1205118568049389783, code=articleTextType, value=kx, createTime=1765260838822, updateTime=1765260838822, creator=18614031015, updator=18614031015), WebsiteProps(id=1205154564300321454, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1205118568049389783, code=banner, value=null, createTime=1765260838818, updateTime=1765260838818, creator=18614031015, updator=18614031015), WebsiteProps(id=1205154564333875892, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1205118568049389783, code=grayFlag, value=0, createTime=1765260838826, updateTime=1765260838826, creator=18614031015, updator=18614031015), WebsiteProps(id=1205154564296127149, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1205118568049389783, code=logo, value=https://castjournals.cast.org.cn/joweb/zgxyylczz/CN/file/pic?fileId=EPNvNLzzPrR2hCakA9eyOQ==, createTime=1765260838817, updateTime=1765260838817, creator=18614031015, updator=18614031015), WebsiteProps(id=1205154564354847414, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1205118568049389783, code=minRunFlag, value=0, createTime=1765260838831, updateTime=1765260838831, creator=18614031015, updator=18614031015), WebsiteProps(id=1205154564312904368, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1205118568049389783, code=picServerUrl, value=https://castjournals.cast.org.cn/joweb/zgxyylczz/CN/file/pic, createTime=1765260838821, updateTime=1765260838821, creator=18614031015, updator=18614031015), WebsiteProps(id=1205154564342264501, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1205118568049389783, code=silenceFlag, value=0, createTime=1765260838828, updateTime=1765260838828, creator=18614031015, updator=18614031015), WebsiteProps(id=1205154564308710063, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1205118568049389783, code=staticResourcePath, value=https://castjournals.cast.org.cn/joweb/cast_kjdb_cn_619/, createTime=1765260838820, updateTime=1765260838820, creator=18614031015, updator=18614031015), WebsiteProps(id=1205154564325487282, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1205118568049389783, code=themeColor, value=null, createTime=1765260838824, updateTime=1765260838824, creator=18614031015, updator=18614031015), WebsiteProps(id=1205154564329681587, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1205118568049389783, code=themeStyle, value=null, createTime=1765260838825, updateTime=1765260838825, creator=18614031015, updator=18614031015)]), Website(id=1205118568124887278, webName=null, webTitle=null, webDomain=null, webCopyrigh=null, webIpcNo=null, seoTitle=null, seoKeywords=null, seoDescription=null, tenantJournalId=null, journalId=1205117082300743687, journalNameCn=null, journalNameEn=null, grayFlag=null, tenantId=1146029695717560320, platformId=null, journalGroupId=null, journalGroupNameCn=null, journalGroupNameEn=null, type=1, domain=https://castjournals.cast.org.cn/joweb/zgxyylczz/EN, language=EN, createTime=1765252256661, createBy=18614031015, updateTime=1765252618802, updateBy=18614031015, name=中国新药与临床杂志-英文, tplId=1146101810881728533, title=Chinese Journal of New Drugs and Clinical Remedies, delFlag=0, indexPage=/home, props=[WebsiteProps(id=1205154594314756492, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1205118568124887278, code=articleTextType, value=kx, createTime=1765260845974, updateTime=1765260845974, creator=18614031015, updator=18614031015), WebsiteProps(id=1205154594297979273, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1205118568124887278, code=banner, value=null, createTime=1765260845970, updateTime=1765260845970, creator=18614031015, updator=18614031015), WebsiteProps(id=1205154594331533711, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1205118568124887278, code=grayFlag, value=0, createTime=1765260845978, updateTime=1765260845978, creator=18614031015, updator=18614031015), WebsiteProps(id=1205154594289590664, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1205118568124887278, code=logo, value=https://castjournals.cast.org.cn/joweb/zgxyylczz/EN/file/pic?fileId=EPNvNLzzPrR2hCakA9eyOQ==, createTime=1765260845968, updateTime=1765260845968, creator=18614031015, updator=18614031015), WebsiteProps(id=1205154594344116625, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1205118568124887278, code=minRunFlag, value=0, createTime=1765260845981, updateTime=1765260845981, creator=18614031015, updator=18614031015), WebsiteProps(id=1205154594310562187, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1205118568124887278, code=picServerUrl, value=https://castjournals.cast.org.cn/joweb/zgxyylczz/EN/file/pic, createTime=1765260845973, updateTime=1765260845973, creator=18614031015, updator=18614031015), WebsiteProps(id=1205154594335728016, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1205118568124887278, code=silenceFlag, value=0, createTime=1765260845979, updateTime=1765260845979, creator=18614031015, updator=18614031015), WebsiteProps(id=1205154594302173578, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1205118568124887278, code=staticResourcePath, value=https://castjournals.cast.org.cn/joweb/cast_kjdb_en_623/, createTime=1765260845971, updateTime=1765260845971, creator=18614031015, updator=18614031015), WebsiteProps(id=1205154594323145101, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1205118568124887278, code=themeColor, value=null, createTime=1765260845976, updateTime=1765260845976, creator=18614031015, updator=18614031015), WebsiteProps(id=1205154594327339406, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1205118568124887278, code=themeStyle, value=null, createTime=1765260845977, updateTime=1765260845977, creator=18614031015, updator=18614031015)])], journalTitle=中国新药与临床杂志, weixinUrl=null, journalUrl=null, iacademicId=null, status=1, seqNo=null, journalTitleEn=Chinese Journal of New Drugs and Clinical Remedies, journalPhotoCn=4CRZH/cEJmlFWJuWhAUDig==, journalPhotoEn=N3vp8/tZorUwVBJknBXdng==, journalFirstLetter=C, journalRecommend=null, journalNew=null, journalCollection=null, jcrJf=null, cjcrJf=null, jcrJfStr=null, cjcrJfStr=null, submissionFirstDecision=null, sciSubjectClassification=null, casSubjectClassification=null, citeScore=null, totalCitationFrequency=null, icpCode=null, psCode=null, advertisingLicenseCode=null, copyrightInformation=null, country=null, option=, provinceCode=null, provinceName=null, collectFlag=false), detailUrlCn=https://castjournals.cast.org.cn/joweb/zgxyylczz/CN/10.14109/j.cnki.xyylc.2024.06.11, detailUrlEn=https://castjournals.cast.org.cn/joweb/zgxyylczz/EN/10.14109/j.cnki.xyylc.2024.06.11, pdfUrlCn=https://castjournals.cast.org.cn/joweb/zgxyylczz/CN/PDF/10.14109/j.cnki.xyylc.2024.06.11, pdfUrlEn=https://castjournals.cast.org.cn/joweb/zgxyylczz/EN/PDF/10.14109/j.cnki.xyylc.2024.06.11, aliStartDate=null, aliEndDate=null, collectionFlag=false, citedCount=null, citedUrl=null, reference=null)
收藏切换
氟比洛芬联合腰方肌阻滞对老年患者全身麻醉肾切除术后神经认知功能及炎症反应的影响
收藏切换
PDF下载
朱曼华 , 应骐潞 , 王玲志 , 周瑞芬
中国新药与临床杂志 | 论著 2024,43(6): 450-454
收起
收藏切换
中国新药与临床杂志 | 论著 2024, 43(6): 450-454
氟比洛芬联合腰方肌阻滞对老年患者全身麻醉肾切除术后神经认知功能及炎症反应的影响
全屏
朱曼华 , 应骐潞, 王玲志, 周瑞芬
作者信息
  • 宁波大学附属李惠利医院 麻醉科，浙江 宁波　315040

    • 朱曼华，女，副主任医师，硕士，主要从事围术期神经认知障碍方面的研究，E-mail：

Effects of flurbiprofen combined with quadratus lumborum block on postoperative neurocognitive function and inflammatory response in elderly patients with nephrectomy under general anesthesia
Man-hua ZHU , Qi-lu YING, Ling-zhi WANG, Rui-fen ZHOU
Affiliations
  • Department of Anesthesiology, the Affiliated Lihuili Hospital of Ningbo University, Ningbo ZHEJIANG 315040, China
出版时间: 2024-06-25 doi: 10.14109/j.cnki.xyylc.2024.06.11
文章导航
收藏切换
摘要
收起
目的

评价氟比洛芬复合腰方肌阻滞对老年患者肾切除术后神经认知功能及炎症反应的影响。

方法

选择择期行腹腔镜肾切除术的老年患者60例，随机分为Q组（腰方肌阻滞组）和FQ组（氟比洛芬联合腰方肌阻滞组），每组30例。麻醉诱导前30 min，2组患者均予以超声引导下手术侧前路腰方肌阻滞。FQ组患者术前10 min静脉注射氟比洛芬1 mg·kg-1，随后2组患者均予以全身麻醉。记录术中丙泊酚、瑞芬太尼用量，术后24 h镇痛泵有效按压次数，评估术后6、24、48 h疼痛视觉模拟量表（VAS）评分及Bruggrmann舒适度量表（BCS）评分。于术前1 d和术后1、7 d采用简易精神状态检查（MMSE）评估患者的神经认知情况，并记录术后7 d内患者术后神经认知障碍（PND）的发生率。检测术前1 h和术后30 min、24 h血高迁移率族蛋白B 1（HMGB1）、白细胞介素（IL）-6的水平。

结果

与Q组相比，FQ组术中瑞芬太尼用量显著减少（P<0.05），术后24 h镇痛泵有效按压次数显著减少（P<0.05）。术后6、24 h，FQ组VAS评分显著低于Q组（P<0.05），BCS评分显著高于Q组（P<0.05）。术后1、7 d，FQ组MMSE评分显著高于Q组（P<0.05）；术后7 d内FQ组PND的发生率显著低于Q组（7% vs. 27%，P<0.05）。术后30 min、24 h，FQ组HMGB1、IL-6水平均显著低于Q组（P<0.05）。2组术后不良反应发生率无显著差异（P>0.05）。

结论

氟比洛芬联合腰方肌阻滞可降低肾切除术老年患者PND的发生率，可能与术后早期完善的镇痛效果及炎症因子水平降低有关。

氟比洛芬  /  老年人  /  肾切除术  /  腹腔镜  /  神经认知障碍  /  腰方肌阻滞  /  炎症反应
AIM

To evaluate the effects of flurbiprofen combined with quadratus lumborum block (QLB) on postoperative neurocognitive function and inflammatory response in elderly patients undergoing nephrectomy.

METHODS

Sixty elderly patients undergoing laparoscopic nephrectomy were randomized into group Q (QLB group) and group FQ (flurbiprofen combined with QLB group), 30 patients in each group. Ultrasound guided anterior QLB were performed in all patients on the surgical side. Patients in group FQ received flurbiprofen 1 mg·kg-1 iv 10 min before surgery. Then both groups received general anesthesia. The dosages of propofol and remifentanil during surgery and the effective number of analgesia pump presses were recorded. The scores of visual analogue scale (VAS) and Bruggrmann comfort scale (BCS) were evaluated at 6, 24, 48 h after surgery. The neurocognitive function was evaluated at 1 d before surgery and 1 d and 7 d after surgery using the mini-mental state examination (MMSE), and the incidence of postoperative neurocognitive disorder (PND) within 7 d after surgery was recorded. Venous blood was collected and the serum levels of high mobility group box protein 1 (HMGB1) and interleukin 6 (IL-6) were tested 1 h before surgery and 30 min and 24 h after the surgery.

RESULTS

Compared with group Q, the dosage of remifentanil was significantly reduced in group FQ (P<0.05), and the effective numbers of analgesia pump presses were reduced in group FQ (P<0.05). At 6, 24 h after surgery, the VAS score was lower, and the BCS score was higher in group FQ than group Q (P<0.05). Compared with group Q, the MMSE score at 1, 7 d after surgery was significantly higher in the group FQ (P<0.05), the incidence of PND within 7 d after surgery was lower in group FQ (P<0.05). The HMGB1 and IL-6 levels at 30 min, 24 h after the surgery were significantly lower in group FQ than group Q (P<0.05).

CONCLUSION

Flurbiprofen combined with QLB can reduce the incidence of PND in elderly patients undergoing nephrectomy, which may be related to the perfect early postoperative analgesia and the decreased levels of inflammatory cytokines.

flurbiprofen  /  aged  /  nephrectomy  /  laparoscopes  /  neurocognitive disorders  /  quadratus lumborum block  /  inflammatory response
朱曼华, 应骐潞, 王玲志, 周瑞芬. 氟比洛芬联合腰方肌阻滞对老年患者全身麻醉肾切除术后神经认知功能及炎症反应的影响. 中国新药与临床杂志, 2024 , 43 (6) : 450 -454 . DOI: 10.14109/j.cnki.xyylc.2024.06.11
Man-hua ZHU, Qi-lu YING, Ling-zhi WANG, Rui-fen ZHOU. Effects of flurbiprofen combined with quadratus lumborum block on postoperative neurocognitive function and inflammatory response in elderly patients with nephrectomy under general anesthesia[J]. Chinese Journal of New Drugs and Clinical Remedies, 2024 , 43 (6) : 450 -454 . DOI: 10.14109/j.cnki.xyylc.2024.06.11
正文
收起
腹腔镜肾切除术已在肾脏肿瘤的治疗中得到广泛应用，与开放手术相比，腹腔镜肾切除术具有切口微创、术后躯体疼痛轻等优点，已广泛应用于老年患者，但术中二氧化碳气腹、腹膜后腔隙钝性分离、病变组织切除等可导致术后高碳酸血症、内脏疼痛、术后谵妄及认知障碍等不良反应[1]。术后神经认知障碍（postoperative neurocognitive disorders，PND）是老年患者围术期常见神经系统并发症，包括学习记忆受损、注意力差、反应迟钝等，与术后急性疼痛、应激、炎症反应等存在相关性[2]。腰方肌阻滞（quadratus lumborum block，QLB）可为肾脏手术患者提供有效的术后镇痛，减少术后舒芬太尼的用量[3]。氟比洛芬（flurbiprofen）为环氧化酶抑制剂，临床广泛用于术后镇痛，且可减轻炎症反应[4]。本研究拟评价氟比洛芬联合QLB对老年患者全身麻醉（全麻）肾切除术后神经认知功能及炎症反应的影响。
资料与方法
收起
病例选择和分组
选择2021年11月至2022年12月在本院行择期腹腔镜肾切除术的老年患者，共60例。纳入标准：ASA分级Ⅱ~Ⅲ级，年龄65~87岁，性别不限，受教育年限6年及以上，简易精神状态检查（MMSE）评分≥24分。排除标准：局部麻醉（局麻）药物过敏，穿刺部位感染，氟比洛芬使用禁忌，严重心、肺、肝、肾功能障碍，精神、神经系统疾病，严重语言表达、视听障碍，长期使用阿片类药物、精神类药物。根据手术时间顺序，采用随机数字表法，将患者分为Q组（QLB组）和FQ组（氟比洛芬联合QLB组），每组30例。研究经本院医学伦理委员会审核通过，伦理批号KY2019PJ018，患者或家属签署知情同意书。
麻醉方法
所有患者入手术室后建立外周静脉通道及右颈内静脉通道，行桡动脉穿刺置管，围术期监测心电图（ECG）、有创动脉血压（IBP）、脉搏氧饱和度（SpO2）、Nacrotrend麻醉深度指数（NI）、体温（T）。麻醉诱导前所有患者取侧卧位，手术侧朝上，将低频（2~5 MHz）超声探头置于髂嵴和肋缘之间，识别L3横突以及呈“三叶草”结构的腰方肌、腰大肌、竖脊肌，穿刺针后外侧向前内侧进针，直至针尖达到腰方肌与腰大肌之间的胸腰筋膜间隙，注入0.25%罗哌卡因（齐鲁制药有限公司，规格为10 mL：75 mg，批准文号为国药准字H20052716）30 mL。操作完成后30 min采用针刺测定T6~T12平面痛觉消失视为QLB成功。FQ组患者术前10 min予以氟比洛芬酯注射液（远大生命科学有限公司，规格为5 mL：50 mg，批准文号为国药准字H20183054）1 mg·kg-1静脉注射（静注）。
所有患者均给予静脉全麻，咪达唑仑0.02 mg·kg-1、依托咪酯0.2 mg·kg-1、舒芬太尼0.3 μg·kg-1、罗库溴铵0.6 mg·kg-1麻醉诱导插管，术中丙泊酚6~8 mg·kg-1·h-1、瑞芬太尼0.1~0.2 μg·kg-1·min-1微泵注射，维持NI值37~57，并间断静注罗库溴铵维持肌松。
术后均采用患者自控静脉镇痛（PCIA），使用氯化钠注射液稀释舒芬太尼1.5 μg·kg-1+托烷司琼7.5 mg至100 mL，背景输注速度2 mL·h-1，单次按压剂量2 mL，锁定时间15 min。术后疼痛视觉模拟量表（VAS）评分≥4分时，给予地佐辛5 mg静注行补救镇痛。
观察指标
（1）麻醉相关指标：记录麻醉时间，术中丙泊酚和瑞芬太尼的用量。（2）术后镇痛及舒适度情况：记录术后24 h内镇痛泵有效按压次数，评估术后6、24、48 h静息状态下疼痛VAS评分及Bruggrmann舒适度量表（BCS）评分[3]。BCS评分为0~4分，0分为持续痛；1分为安静时无痛，深呼吸或咳嗽时剧烈痛；2分为深呼吸或咳嗽时轻微痛；3分为深呼吸时无痛；4分为咳嗽时无痛。（3）认知情况：于术前1 d和术后1、7 d采用MMSE评估患者的神经认知情况，所有患者MMSE均采用问卷星进行，并记录术后7 d内PND的发生率。MMSE评分27~30分为正常，<27分为认知功能障碍，术后MMSE评分较术前基础值下降≥1个标准差，则评估为PND[5]。（4）炎症指标：术前1 h和术后30 min、24 h采集静脉血，采用ELISA法检测血浆高迁移率族蛋白B1（HMGB1）、白细胞介素（IL）-6的水平。（5）不良反应：观察术后恶心呕吐、皮肤瘙痒、血肿，QLB后局麻药中毒及消化道出血等的发生情况。
统计学分析
采用SPSS 24.0软件进行统计处理。正态分布的计量资料以表示，组间比较采取t检验，组内不同时点比较采用重复测量设计的方差分析；偏态分布的计量资料比较采用秩和检验；计数资料比较采用χ2检验。P<0.05为差异有显著差异。
结果
收起
一般资料
2组患者性别、年龄、ASA分级、体重指数（BMI）等比较，差异均无显著意义（P>0.05）。见表1。
麻醉、术后镇痛及舒适度情况
2组麻醉时间、术中丙泊酚用量比较，差异无显著意义（P>0.05）。FQ组术中瑞芬太尼用量显著少于Q组（P<0.05）。与Q组相比，FQ组术后24 h内镇痛泵有效按压次数显著减少（P<0.05）。术后6、24 h，FQ组静息状态VAS评分显著低于Q组（P<0.05），BCS评分显著高于Q组（P<0.05）。术后48 h，2组静息VAS评分及BCS评分比较，差异无显著意义（P>0.05）。见表2。
认知情况及炎症指标
术前1 d，2组MMSE评分比较差异无显著意义（P>0.05）；术后1、7 d，FQ组MMSE评分显著高于Q组（P<0.05）；术后7 d内FQ组PND的发生率显著低于Q组（P<0.05）。术前1 h，2组HMGB1、IL-6水平比较无显著差异（P>0.05）；术后30 min、24 h，FQ组HMGB1、IL-6水平均显著低于Q组，差异有显著意义（P<0.05）。见表3。
不良反应
2组均未出现血肿、局麻药中毒及消化道出血。Q组术后发生恶心呕吐16例（53%）、皮肤瘙痒8例（27%），FQ组发生恶心呕吐15例（50%）、皮肤瘙痒10例（33%），2组恶心呕吐、皮肤瘙痒发生率比较，差异均无显著意义（P>0.05）。
讨论
收起
老年患者由于生理机能退化，对手术创伤的耐受力较差，术后并发症发生率较高，如术后谵妄、神经认知障碍等，影响术后康复[6]。2018年，围术期认知命名工作组将PND作为术前、术后诊断神经认知障碍的总称，包括术前存在的认知障碍、术后谵妄、神经认知恢复延迟及术后认知障碍[2]，时间跨度为术前至术后12个月。其中术后神经认知恢复延迟的发生时间为术后7 d至术后30 d。因此，本研究中术后早期认知功能评估最长时间点选择了术后7 d。目前，关于PND的预防及治疗仍处于探索阶段，国内外研究证实PND的发生机制与患者年龄、麻醉药物用量、术后急性疼痛、围术期应激、炎症等有关[7]。超声引导区域阻滞联合全麻可增强围术期镇痛效果，减少麻醉药物用量，并改善术后康复质量[8]。QLB是一种临床应用广泛的腹部区域阻滞技术，可为腹部手术患者提供良好的术后镇痛且安全性较高，注射位点不同的入路阻滞所产生的镇痛范围及效果也不同[9]。本研究采取前路QLB阻滞，即将局麻药物注射于腰方肌的前侧及腰大肌后侧之间的胸腰筋膜层，可阻滞该部位内的交感神经及机械感受器，药物还可沿胸腰筋膜扩散至椎旁间隙，对躯体痛及内脏痛均能起到缓解作用。本研究受试对象为老年患者，为减少不良反应，选择了低浓度的局麻药，且总使用剂量亦较低，即0.25%罗哌卡因30 mL，保障了QLB的安全性。
氟比洛芬为非甾体抗炎药，已有研究证实其可抑制炎性细胞因子的释放从而改善髋关节手术患者术后神经认知功能，且氟比洛芬1 mg·kg-1即可明显降低PND的发生率[10]。因此，本研究采用了氟比洛芬1 mg·kg-1静注，结果显示，与Q组相比，FQ组术中瑞芬太尼用量、术后24 h内镇痛泵按压次数减少，术后6、24 h静息状态VAS降低，而BCS评分升高，均说明术前氟比洛芬联合QLB可显著减少术中阿片类药物的使用量，术后早期镇痛效果更佳，术后24 h内患者舒适度更高。术前使用氟比洛芬可抑制前列腺素的合成，靶向性聚集于创伤部位，产生超前镇痛作用[11]。而前路QLB产生的感觉阻滞范围最大可达T4~L2，能有效抑制肾切除术后的躯体痛，局麻药物扩散至椎旁间隙还可抑制内脏痛[3]。故该两种镇痛模式相结合可产生更佳的术后镇痛效果，从而提高患者术后舒适度。
本研究中术后1、7 d，FQ组MMSE评分均高于Q组，且术后7 d内PND的发生率更低，提示氟比洛芬联合QLB可提高肾切除术老年患者术后认知功能。研究表明，术中麻醉药物用量大、手术创伤所致的急性疼痛等均可影响老年患者术后的神经功能，导致PND的发生[12]。本研究中FQ组术中瑞芬太尼用量较少及术后更完善的镇痛效果可能为PND发生率较低的原因之一。
目前大量研究证实手术创伤引起的围术期炎症反应可破坏血脑屏障并导致神经炎症反应、神经元损伤等，引起PND的发生[7]。本研究中，术后30 min、24 h，FQ组HMGB1、IL-6水平均低于Q组，提示氟比洛芬联合QLB可减少术后24 h内血炎症因子浓度。氟比洛芬可通过抑制环氧化酶，调节免疫、抑制炎症因子的释放；此外，其超前镇痛作用可有效地抑制应激反应，起到抗炎作用[10]。作为一种核蛋白，HMGB1可参与海马炎症反应，导致认知功能下降；IL-6则可通过血脑屏障直接影响中枢神经系统功能，腹腔镜胃癌根治术老年患者术后HMGB1、IL-6水平的升高与PND的发生相关[13]。由此推测，氟比洛芬联合QLB可能通过抑制术后炎症因子的释放，改善老年患者术后认知功能。
综上所述，氟比洛芬复合QLB用于行肾切除术老年患者，术后镇痛更完善，患者舒适度更高，可抑制术后炎症反应，降低PND的发生率。但本研究的样本量较少，且未对术后长期神经认知功能进行研究，因此本研究结果尚需要大样本、长时间临床试验进一步验证。
基金
收起
  • 浙江省医药卫生科技计划项目(2020KY866)
文献
收起
参考文献 引证文献
排序方式：
[1]
NASRALLAH G，SOUKI FG. Perianesthetic management of laparoscopic kidney surgery [J]. Curr Urol Rep, 2018, 19 （1）:1-8.
[2]
EVERED L, SILBERT B, KNOPMAN DS, et al. Recommendations for the nomenclature of cognitive change associated with anaesthesia and surgery-2018[J]. Anesthesiology, 2018, 129 （5）: 872-879.
[3]
ZHU MH, QI Y, HE HJ, et al. Analgesic effect of the ultrasound-guided subcostal approach to transmuscular quadratus lumborum block in patients undergoing laparoscopic nephrectomy: a randomized controlled trial[J]. BMC Anesthesiol, 2019, 19（1）:154.
[4]
WU H, TANG C, TAI LW, et al. Flurbiprofen axetil attenuates cerebral ischemia/ reperfusion injury by reducing inflammation in a rat model of transient global cerebral ischemia / reperfusion[J].Biosci Rep, 2018, 38 （4）: BSR20171562.
[5]
段振馨, 段光友, 李 洪. 围术期神经认知障碍诊断方法、流程及注意事项的研究进展 [J]. 临床麻醉学杂志, 2019, 35（10）: 1026-1029.
[6]
赵雨帆, 欧阳文, 胡中华, 等. 老年患者围术期神经认知障碍与术后急性疼痛的研究进展[J]. 临床麻醉学杂志, 2021, 37（5）: 542-545.
[7]
EVERED LA, SILBERT BS. Postoperative cognitive dysfunction and noncardiac surgery[J]. Anesth Analg, 2018, 127 （2）: 496-505.
[8]
GOLLAPUDY S, GASHKOFF DA, POETKER DM, et al. Surgical field visualization during functional endoscopic sinus surgery:comparison of propofol- vs desflurane-based anesthesia[J].Otolaryngol Head Neck Surg, 2020, 163 （4）: 835-842.
[9]
ELSHARKAWY H, EL-BOGHDADLY K, BARRINGTON M.Quadratus lumborum block: anatomical concepts, mechanisms, and techniques[J]. Anesthesiology, 2019, 130（2）: 322-335.
[10]
战海燕, 周 琪, 张析哲, 等. 不同剂量氟比洛芬酯对老年全髋关节置换术患者术后神经认知功能的影响[J]. 临床麻醉学杂志, 2020, 36 （7）: 638-642.
ZHAN HY, ZHOU Q, ZHANG XZ, et al. Effects of different doses of flurbiprofen on neurocognitive function in elderly patients undergoing total hip arthroplasty[J].J Clin Anesthesiol, 2020, 36 （7）: 638-642.
[11]
YOSHIDA M, SHIMIZU Y, YOSHIDA K, et al. Effective postoperative analgesia using intravenous flurbiprofen and acetaminophen [J]. J Oral Maxillofac Surg, 2018, 76 （9）: 1869-1872.
[12]
刘 彦. 麻醉深度对高龄患者全麻手术 POCD 的影响及其作用机制[J]. 中国老年学杂志, 2020, 40 （2）: 329-331.
[13]
ZHU MH, QI Y, HE HJ, et al. Effect of quadratus lumborum block on postoperative cognitive function in elderly patients undergoing laparoscopic radical gastrectomy: a randomized controlled trial [J].BMC Geriatr, 2021, 21（1）: 238.
2024年第43卷第6期
PDF下载
79
39
引用本文
BibTeX
文章信息
doi: 10.14109/j.cnki.xyylc.2024.06.11
  • 接收时间：2023-04-20
  • 首发时间：2026-03-20
  • 出版时间：2024-06-25
补充材料
相关文章
文章信息
作者
出版历史
  • 收稿日期：2023-04-20
  • 录用日期：2024-02-28
基金
浙江省医药卫生科技计划项目(2020KY866)
作者信息
    宁波大学附属李惠利医院 麻醉科，浙江 宁波　315040
参考文献
分享链接
https://castjournals.cast.org.cn/joweb/zgxyylczz/CN/10.14109/j.cnki.xyylc.2024.06.11
分享至
全文二维码

扫描看全文

引用本文
BibTeX
本文的引用情况
2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
关闭全屏
相关链接
论文
最新文章
热读文章
热点专题
内参
蓝皮书
产业发展报告
传播力报告
期刊分级目录
资讯
学术新闻
行业新闻
学术会议
行业会议
关于
关于我们
联系我们
北京市海淀区学院南路86号
100081
010-62199257
qkjq@cast.org.cn

中国科学技术协会版权所有 京ICP 备10216604号-4 海淀分局备案 1101084647
科技导报社主办 中国科协信息中心技术支持