髋关节置换术老年患者血清IL6水平与术后早期认知功能障碍的关系临床医学.doc

髋关节置换术老年患者血清IL6水平与术后早期认知功能障碍的关系临床医学 目录 TOC \o 1-9 \h \z \u 目录 1 正文 1 文1：髋关节置换术老年患者血清IL6水平与术后早期认知功能障碍的关系临床医学 1 1 资料与方法 3 2 结果 4 3 讨论 5 文2：慢性阻塞性肺病患者血清对氧磷酶水平与全身炎症反应的关系临床医学 6 1 资料与方法 7 2 结 果 8 3 讨 论 9 参考文摘引言： 11 原创性声明（模板） 13 文章致谢（模板） 13 正文 髋关节置换术老年患者血清IL6水平与术后早期认知功能障碍的关系临床医学 文1：髋关节置换术老年患者血清IL6水平与术后早期认知功能障碍的关系临床医学 【Abstract】 Objective To investigate the relatiohip with levels of serum interleukin-6 and early POCD in elderly patients undergoing hip joint replacement. Methods 33 elderly patients undergoing selective hip joint replacement with ASA physical status II were randomly divided into two groups: group G and group E. Patients in group G received combined intravenous-inhalation anesthesia and endotracheal intubation. Patients in group E received combined spinal-epidural anaesthesia. No premedication was given before surgery. Intraoperative shrink blood pressure (SBP) was maintained within 25% of baseline value and pulse oxygen saturation (SpO2) kept above 95%. Intravenous fentanyl (%, 2ml/h) provided 48h postoperative analgesia. MMSE scores were recorded before anesthesia or at 3h, 6h, 1d, and 3d after operation. The cervical venous blood samples were obtained before anesthesia or at 3h and 6h after operation for detecting the levels of serum IL-6. Results Compared with preoperation, MMSE scores in all the patients decreased significantly at 3h, 6h and 1d after operation (P), and returned to preoperative levels at 3d after surgery. MMSE scores were significantly lower in group G at 3h and 6h after operation than those in group E (P). The incidence of POCD in group G is 67%,27%,20% at 3h,6h and 1d after operation, and in group E is 22%,17%,11% respectively. The incidence of POCD was significantly higher in group G than that in group E at 3h after operation (P). Serum IL-6 levels in all the patients were significantly decreased at 3h and 6h after operation (P). Serum IL-6 levels was significantly higher in group G than that in grou