目的研究依达拉奉在脑缺血再灌注损伤中的保护作用及机制。方法根据随机数字表法将2016年3月至2018年3月西电集团医院接收的脑缺血再灌注损伤患者120例分为对照组和观察组各60例,对照组予以阿司匹林联合奥扎格雷钠氯化钠注射液治疗,观察组则在此基础上加用依达拉奉治疗。将两组脑缺血再灌注损伤患者的美国国立卫生院神经功能缺损量表(national institute of health stroke scale,NIHSS)评分、日常生活能力评定量表(activities of daily living,ADL)评分、治疗效果、血清学指标进行比对。结果观察组脑缺血再灌注损伤患者治疗后的NIHSS评分低于对照组,差异有显著性(P<0.05);观察组患者治疗后的ADL评分、临床总有效率及超氧化物歧化酶(superoxide dismutase,SOD)活性均高于对照组,差异有显著性(P<0.05);观察组治疗后的血清神经元特异性烯醇酶(neuron-specific enolase,NSE)、丙二醛(malondialdehyde,MDA)、内皮素(endothelin,ET)、血清超敏C反应蛋白(hypersensitive C-reactive protein,hsCRP)含量均低于对照组,差异有显著性(P<0.05)。结论依达拉奉有助于脑缺血再灌注损伤情况的改善,对患者的神经功能起到保护作用。
随着世界各地人口年龄和预期寿命的增加,预计发生髋部骨折的老年人数量将逐年增多。髋部骨折好发于老年患者,早期手术修复作为其关键治疗方式能最大限度地减少并发症、降低死亡率,老年患者髋部手术后谵妄的发生率在4%~53%之间,是老年患者最常见的手术并发症,与功能预后不良、住院时间延长及死亡率升高有关。术后谵妄的危险因素众多,有研究表明多达三分之一的高危患者可以预防谵妄的发生。针对其危险因素背后的机制探索可能帮助我们能更好地筛查和预防,更有针对性地制定围术期的医疗保健计划,从而在髋部骨折治疗后获得尽可能好的手术结果和更好的生活质量。As the age and life expectancy of populations around the world increase, the number of older people suffering hip fractures is expected to increase year by year. Hip fracture tends to occur in elderly patients, and early surgical repair as a key treatment can minimize complications and reduce mortality. The incidence of postoperative delirium in elderly patients ranges from 4% to 53%, and it is the most common surgical complication in elderly patients, which is associated with poor functional prognosis, prolonged hospital stay and increased mortality. There are many risk factors for postoperative delirium. Studies have shown that up to a third of high-risk patients can prevent delirium. Exploring the mechanism behind the risk factors may help us to better screen and prevent them, and develop a more targeted perioperative health care plan, so as to obtain the best possible surgical outcome and better quality of life after hip fracture treatment.
