Effect of ulinastatin on post-operative cognition disorders in elderly patients undergoing hip joint replacement.
- Author:
Ya-Mei KANG
1
;
Ye-Ying GE
;
Jian-Qing CHENG
;
Yue-Bo CHEN
;
Na YUAN
;
Liu-Jun ZHAO
;
Rong-Ming XU
Author Information
- Publication Type:Journal Article
- MeSH: Aged; Arthroplasty, Replacement, Hip; adverse effects; Cognition Disorders; blood; drug therapy; Female; Glycoproteins; therapeutic use; Humans; Male; Nerve Growth Factors; blood; Postoperative Complications; blood; drug therapy; S100 Calcium Binding Protein beta Subunit; S100 Proteins; blood
- From: China Journal of Orthopaedics and Traumatology 2010;23(5):355-358
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo evaluate the effect of ulinastatin on post-operative Cognition disorders in elderly patients undergoing hip joint replacement.
METHODSForty ASA I or II elderly patients undergoing selective hip joint replacement, aged > or = 65 years, were randomly divided into 2 groups (n = 40 each): control group and ulinastatin group. Ulinastatin group received iv infusion of ulinastatin (10,000 u/kg) after skin incision, (5,000 U/kg) after operation 1, 2, 3 d respectively, included 21 males and 19 females with an average age of (75.00 +/- 7.81) years old. Control group received the same volume of normal saline instead of ulinastatin, included 20 males and 20 females with an average age of (72.80 +/- 7.25) years old. Neuroeognitive testing was performed on the preoperative day and on the 3th postoperative day and post-operative cognition disorders was defined as 1 SD decline from baseline on neurocognitive assessment. Serum S100beta protein were measured before operation, at the end of surgery, 3, 24 h and 3 d after operation.
RESULTSThe incidence rate of postoperative cognition disorders was 2.5% in ulinastatin group, there were lower than those of patients in the control group (25%) (P < 0.05); In control group, the scales for MMSE before and after operation were (25.2 +/- 2.1), (22.6 +/-2.5) scores and the level of serum S100beta protein at T0-4 were (0.041 +/- 0.012), (0.125 +/- 0.031), (0.178 +/- 0.036), (0.142 +/- 0.038), (0.048 +/- 0.015) microg/L. As well in ulinastatin group, above date were (25.9 +/- 2.4), (24.8 +/- 2.1), (0.040 +/- 0.013), (0.095 +/- 0.021), (0.116 +/- 0.017), (0.087 +/- 0.019) and (0.043 +/- 0.012) respectively. Compared with preoperative, MMSE evaluation scale was decreased on the 3th postoperative day and the S100beta was increased markedly at T1-3 in control group (P < 0.05); Compared with control group, MMSE evaluation scale was increased and the S100beta was decreased markedly at T1-3 in ulinastatin group (P < 0.05 ).
CONCLUSIONIntravenous infusion of ulinastatin during operation can prevent the occurrence of POCD in elderly patients.
