右美托咪定复合喷他佐辛对全髋关节置换老年患者术后炎性反应及高凝状态的影响

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Abstract Objective To study the effect of Dexmedetomidine combined with Pentazocine on postoperative inflammatory response and hypercoagulability in elderly patients underwent total hip replacement. Methods From May 2016 to May 2017, 300 elderly patients who underwent total hip replacement in the Second Hospital of Qinhuangdao were selected as the study subjects. The patients were divided into study group and control group by random number table method, with 150 cases in each group. The control group was treated with Pentazocine for analgesic treatment, and the study group was treated with Dexmedetomidine combined with Pentazocine for analgesic treatment. The postoperative inflammatory response, hypercoagulability, postoperative pain at different time and adverse reactions were compared between the two groups. Results There were no significant differences in serum levels of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) between the two groups at immediate preoperative and immediate postoperative (P ＞ 0.05), the levels of IL-6 and TNF-α in the two groups at immediate postoperative and postoperative 24 hours were significantly higher than those at immediate preoperative, but the levels of IL-6 and TNF-α in the study group were lower than those in the control group at postoperative 24 hours, the differences were statistically significant (P ＜ 0.05). There were no significant differences in the levels of D-dimer and fibrinogen (Fib) between the two groups at immediate preoperative and immediate postoperative (P ＞ 0.05), the levels of D-dimer and Fib in the two groups at immediate postoperative and postoperative 24 hours were significantly higher than those at immediate preoperative, but the levels of D-dimer and Fib in the study group were lower than those in the control group at postoperative 24 hours, the differences were statistically significant (P ＜ 0.05). Visual analogue scale (VAS) scores in the study group were significantly lower than those in the control group at postoperative 6, 12, 24 hours (P ＜ 0.05). The incidence of gastrointestinal reactions and vertigo in the study group were significantly lower than those in the control group (P ＜ 0.05), and there was no significant difference in the incidence of hypertension between the two groups (P ＞ 0.05). Conclusion Dexmedetomidine combined with Pentazocine can effectively improve the inflammatory response and hypercoagulability in elderly patients underwent total hip replacement, and effectively alleviate the pain, and also has a good safety.

Key words： Total hip replacement Dexmedetomidine Pentazocine Inflammatory response Hypercoagulability

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	LI Guangwei DONG Fusheng

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LI Guangwei DONG Fusheng. Effects of Dexmedetomidine combined with Pentazocine on postoperative inflammatory response and hypercoagulability in elderly patients underwent total hip replacement[J]. 中国医药导报, 2019, 16(7): 105-108.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2019/V16/I7/105

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