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目的:观察塞来昔布对老年髋部骨折患者术后炎性反应和早期认知功能的影响。方法:选取2017年7月至2019年7月在上海市松江区方塔中医医院采用相同麻醉方法行手术治疗的老年髋部骨折患者130例，按随机数字表法分为塞来昔布组（66例）和对照组（64例）。塞来昔布组患者分别在术前12 h和术后12、24、48 h口服塞来昔布200 mg，对照组患者在相同时间服用安慰剂，术后均采用舒芬太尼静脉镇痛泵镇痛。检测术前12 h及术后4、24、48 h血清C反应蛋白（CRP）、白细胞介素（IL）-6、肿瘤坏死因子（TNF）-α、前列腺素En 2（PG-En 2）水平；术后1、4、24和48 h采用疼痛视觉模拟量表（VAS）评估疼痛强度；术前和术后第7天采用简易精神状态量表（MMSE）评估认知功能，术后第7天MMSE0.05）；塞来昔布组术后24和48 h VAS评分明显低于对照组[（4.3 ± 1.2）分比（6.1 ± 1.6）分和（4.0 ± 0.9）分比（7.8 ± 1.3）分]，差异有统计学意义（n P0.05）；塞来昔布组术后4、24和48 h CRP、IL-6、TNF-α和PG-En 2明显低于对照组，差异有统计学意义（n P0.05）；塞来昔布组术后第7天MMSE评分明显高于对照组[（25.1 ± 1.9）分比（23.9 ± 1.5）分]，POCD发生率明显低于对照组[10.6%（7/66）比28.1%（18/64）]，差异有统计学意义（n P<0.05）。n 结论:塞来昔布可降低老年髋部骨折患者术后POCD的发生率，其作用可能是通过抑制围手术期炎性反应和术后急性疼痛得以实现的。“,”Objective:To evaluate the effects of celecoxib on postoperative cognitive function in elderly patients with hip fracture.Methods:One hundred and thirty patients with hip fracture patients from July 2017 to July 2019 in Shanghai Songjiang Fangta Hospital of Traditional Chinese Medicine were selected. All patients were treated with the same anesthetic and surgical methods. The patients were divided into celecoxib group (66 patients) and control group (64 patients) by random number table method. The patients in celecoxib group were given oral administration of celecoxib 200 mg 12 h before surgery and 12, 24, 48 h after surgery; the patients in control group were given oral administration of placebo at the same time. Patients were treated with sufentanil intravenous analgesia pump. The serum levels of C reactive protein (CRP), interleukin (IL)-6, tumor necrosis factor (TNF)-α and prostaglandin En 2 (PG-En 2) 12 h before surgery and 4, 24, 48 h after surgery were determined. The pain intensity 1, 4, 24 and 48 h after surgery was measured by visual analogue scale (VAS) score. Cognitive function before surgery and 7 d after surgery was assessed by mini-mental state examination (MMSE), and the MMSE 7 d after surgery 0.05); the VAS score 24 and 48 h in celecoxib group was significantly lower than that in control group: (4.3 ± 1.2) scores vs. (6.1 ± 1.6) scores and (4.0 ± 0.9) scores vs. (7.8 ± 1.3) scores, and there was statistical difference (n P0.05); the CRP, IL-6, TNF-α and PG-En 2 4, 24 and 48 h after surgery in celecoxib group were significantly lower than those in control group, and there were statistical differences (n P0.05); MMSE 7 d after surgery in celecoxib group was significantly higher than that in control group: (25.1 ± 1.9) scores vs. (23.9 ± 1.5) scores, the incidence of POCD was significantly lower than that in control group: 10.6% (7/66) vs. 28.1% (18/64), and there were statistical differences (n P<0.05).n Conclusions:Celecoxib can decrease early POCD incidence after hip fracture surgery in elderly patients, which might be mediated by suppressing inflammation and acute postoperative pain caused by surgical trauma.