[关键词]
[摘要]
目的:探讨头部亚低温治疗对老年病人全髋关节置换手术后早期认知功能的影响。方法: ASAⅡ或
Ⅲ级择期拟行全髋关节置换术病人60 例，排除术前认知功能障碍或存在公认的影响认知功能的因素，随机分为
亚低温组( S) 、正常体温组( C) ，分析两组病人手术情况，应用简易精神状态量表MMSE 对两组病人术前和术后
1d 的认知功能状态进行评估。观察病人自主呼吸恢复、呼之睁眼以及拔管时间。并在术前( T1) 、术后1h( T2) 、
术后6h( T3) 、术后72h( T4) 四个时点分别抽取静脉血，采用酶联免疫吸附法( ELISA) 测定血清S100β 蛋白的浓
度。结果:亚低温组病人术后认知功能障碍发生率低于正常体温组( P＜0．05) 。两组病人术后1d 的MMSE 评分
均下降，亚低温组术后1d MMSE 评分显著高于正常体温组，差异具有统计学意义( P＜0．05) 。术后1、6h 两组
S100β 蛋白浓度均比术前明显下降，亚低温组术后6h 时S100β 蛋白浓度低于正常体温组，差异有统计学意义( P
＜0．05) 。结论:老年病人全髋关节置换术中进行头部亚低温治疗，可改善术后早期认知功能。
[Key word]
[Abstract]
Objective:To investigate the effect of head mild hypothermia on early postoperative
cognitive function in elderly patients with total hip replacement．Methods:60 patients，ASA II or III
scheduled for total hip arthroplasty，excluding preoperative cognitive impairment or recognized factors
which affect cognitive function，were randomly divided into mild hypothermia group(Group S)，normal
temperature group(Group C)．At the preoperative and postoperative 1 day，using mini－mental state examination
MMSE to evaluate the cognitive function of the patients．Observed spontaneous breathing recovery
time，extubation time，called the open time of patients．Before induction(T1)、1h(T2)、6h(T3)、
72h(T4)after operation，taking blood samples to test the serum concentrations of S100β by using the
method of ELISA．Results:The incidence of postoperative cognitive dysfunction in mild hypothermia
group was lower than that in normal temperature group(P＜0．05)．The MMSE scores of the two groups
were decreased after operation，MMSE score of the sub hypothermia group was significantly higher than
that of the normal group at the first day after surgery，and the difference was statistically significant(P＜
0．05)．Compared with S100β protein at T1，that at T2，T3 were higher，S100β protein at T3 in Group S
was lower than that in Group C，and there was significant differences(P＜0．05)．Conclusion:Head mild
hypothermia treatment in elderly patients with total hip arthroplasty can improve the early postoperative
cognitive function．
[中图分类号]
R 614．2
[基金项目]
收稿日期: 2017－02－03;修回日期: 2017－03－05
基金项目: 内蒙古自治区自然科学基金项目(Kjt 15 MS(LH)803)
作者简介: 石海霞(1982－)，女，内蒙古医科大学附属医院麻醉科主治医师。
通讯作者: 温再和，主任医师，E－mail:haixia0403@ 163．com 内蒙古医科大学附属医院麻醉科，010050
