右美托咪定对结直肠癌腹腔镜手术老年患者术后认知功能障碍及血清神经元烯醇化酶、S100β蛋白、肿瘤坏死因子-α水平的影响

发布时间：2018-05-30 10:41

本文选题：右美托咪定 + 术后认知功能障碍　；参考：《中国老年学杂志》2017年06期

【摘要】：目的探讨右美托咪定对结直肠癌腹腔镜手术老年患者术后认知功能障碍及血清神经元烯醇化酶(NSE)、S100β蛋白、肿瘤坏死因子(TNF)-α水平的影响。方法行结直肠癌腹腔镜手术的96例老年患者随机分为对照组和试验组各48例。诱导麻醉后,对照组泵注给予生理盐水,试验组泵注给予右美托咪定。应用简易精神状态量表(MMSE)对患者术前、术后1、3 d进行评分,统计并比较两组MMSE评分。计算并比较两组术后3 d的认知功能障碍发生率。检测并比较两组术前、术后1、3 d血清NSE、S100β蛋白及TNF-α水平。结果试验组术后3 d的认知功能障碍发生率明显低于对照组(P0.05);对照组术后1、3 d MMSE评分均明显低于术前(P0.05),且低于试验组(P0.05)。两组术后1 d血清NSE水平明显高于术前,且试验组明显低于对照组,术后1、3 d血清S100β蛋白水平明显高于术前,TNF-α水平明显低于术前,且试验组S100β蛋白、TNF-α水平均明显低于对照组(均P0.05)。结论右美托咪定能够明显改善结直肠癌腹腔镜手术老年患者术后认知功能,降低认知功能障碍发生率,降低血清NSE、S100β蛋白及TNF-α水平。
[Abstract]:Objective to investigate the effects of dexmetomidine on cognitive impairment, serum neuron enolase (NSE) S100 尾 protein and tumor necrosis factor TNF- 伪 level in elderly patients undergoing laparoscopic surgery for colorectal cancer. Methods 96 elderly patients undergoing laparoscopic colorectal cancer surgery were randomly divided into control group (n = 48) and trial group (n = 48). After induction anesthesia, the control group was injected with normal saline, and the experimental group with dexmetomidine. The patients were evaluated with MMSE before operation and 1 day after operation. The scores of MMSE were compared between the two groups. The incidence of cognitive dysfunction was calculated and compared 3 days after operation between the two groups. Serum NSES100 尾 protein and TNF- 伪 were measured and compared between the two groups before and 1 day after operation. Results the incidence of cognitive dysfunction in the trial group was significantly lower than that in the control group on the 3rd day after operation, and the MMSE score in the control group was significantly lower than that in the control group on the 1st and 3rd day after operation, and was lower than that in the experimental group. The serum NSE level was significantly higher in the two groups on the 1st day after operation than before operation, and the level of serum S100 尾 protein in the experimental group was significantly lower than that in the control group, and the level of serum S100 尾 protein on the 1st day after operation was significantly higher than that in the preoperative TNF- 伪 group. The levels of S100 尾 protein TNF- 伪 in the experimental group were significantly lower than those in the control group (all P 0.05). Conclusion dexmetomidine can significantly improve the cognitive function, reduce the incidence of cognitive dysfunction and decrease the levels of serum NSES100 尾 protein and TNF- 伪 in elderly patients with colorectal cancer undergoing laparoscopic surgery.
【作者单位】：福建医科大学附属第一医院麻醉科;福州市传染病院麻醉科;
【基金】：福建省教育厅一般项目(No.JA15214)
【分类号】：R614;R735.34

【参考文献】