摘要譯文（供參考）

上午手術(shù)或下午手術(shù)對(duì)老年患者術(shù)后睡眠質(zhì)量和褪黑素水平的影響：

一項(xiàng)前瞻性隨機(jī)研究

??目的：??

術(shù)后睡眠障礙不利于患者術(shù)后恢復(fù)。本研究旨在確定手術(shù)時(shí)間（上午與下午）對(duì)老年患者術(shù)后睡眠質(zhì)量的影響，并分析手術(shù)時(shí)間與褪黑素水平變化之間的關(guān)系。

??方法：??

將60例接受髖關(guān)節(jié)手術(shù)的患者隨機(jī)分為上午組（M組）和下午組（A組）。

睡眠質(zhì)量采用Richards Campbell睡眠問卷進(jìn)行評(píng)估。

手術(shù)前后，在12小時(shí)內(nèi)收集夜間尿液，并測(cè)量6-硫氧基褪黑素濃度。

此外，還觀察了術(shù)后譫妄（POD）的發(fā)生率。

??結(jié)果：??

術(shù)后第1、2晚，A組患者的睡眠質(zhì)量得分高于M組，術(shù)后第3晚兩組患者睡眠質(zhì)量得分無差異（P=0.000，P=0.002，P>0.05）。

此外，在手術(shù)的第一晚，A組的尿液6-硫氧基褪黑素濃度高于M組（P=0.00）。

術(shù)后睡眠質(zhì)量評(píng)分和尿6-硫氧基褪黑素濃度均顯著低于術(shù)前（P=0.00，P=0.00）。

??結(jié)論：??

老年全麻髖關(guān)節(jié)手術(shù)患者術(shù)后睡眠質(zhì)量評(píng)分和褪黑素水平明顯低于術(shù)前。

此外，下午接受手術(shù)的患者的短期睡眠質(zhì)量?jī)?yōu)于早上接受手術(shù)的病人。

這種差異可能與手術(shù)后褪黑激素水平的短期變化有關(guān)。

??關(guān)鍵詞：??

褪黑素；睡眠質(zhì)量；手術(shù)時(shí)機(jī)。

圖1 CONSORT流程圖。

圖2兩組患者術(shù)前和術(shù)后三天內(nèi)RCSQ評(píng)分的比較。

圖3手術(shù)前一晚、術(shù)后第一晚和第二晚各組6-SMT尿排泄量的比較。

????原文摘要????

The Impact of Morning Surgery or Afternoon Surgery on Postoperative Sleep Quality and Melatonin Levels of Elderly Patients:

 A Prospective, Randomized Study

??Objective:?? 

Postoperative sleep disturbance after surgery is not conducive to the recovery of patients. The purpose of this study was to determine the influence of the timing of surgery (morning vs afternoon) on the postoperative sleep quality of elderly patients and to analyze the relationship between the timing of surgery and the change in the melatonin level.

??Methods: ??

Sixty patients who received hip surgery were randomly assigned to the Morning Group (Group M) or the Afternoon Group (Group A). The sleep quality was assessed by the Richards-Campbell Sleep Questionnaire. Before and after surgery, the nocturnal urine was collected over a 12-h period, and the 6-sulfatoxymelatonin concentration was measured. Also, the incidence of postoperative delirium (POD) was observed.

??Results:?? 

On the first and second nights after surgery, the sleep quality scores of the patients in Group A were greater than those in Group M, and there was no difference in the sleep quality scores between the two groups on the third night after surgery (P=0.000, P=0.002, P>0.05, respectively). In addition, the urine 6-sulphatoxymelatonin concentration was found to be greater in Group A than in Group M on the first night of surgery (P=0.00). Both the postoperative sleep quality scores and urine 6-sulphatoxymelatonin concentration were significantly less than those before surgery (P=0.00, P=0.00).

??Conclusion: ??

The postoperative sleep quality scores and melatonin levels of elderly patients who received hip surgery under general anesthesia were significantly less than those of the patients before surgery. Furthermore, the short-term sleep quality of the patients who received surgery in the afternoon was better than that of the patients who received surgery in the morning. This difference may be related to the short-term change of the melatonin level after surgery.

??Keywords: ??

melatonin; sleep quality; timing of surgery.

Figure 1 The CONSORT flowchart.

Figure 2 Comparison of RCSQ scores before surgery and within three days after surgery between the two groups.

Figure 3 Comparison between groups of urinary excretion of 6-SMT during the night before surgery, and the first and second postoperative nights

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