经皮穴位电刺激对老年患者腹腔镜直肠癌切除术后认知功能的影响研究

发布时间：2018-09-03 20:34

【摘要】：目的探讨经皮穴位电刺激(TAES)对老年患者腹腔镜直肠癌切除术后认知功能的影响及其可能的机制。方法选择2011年6月—2014年5月温州医科大学附属第一医院肿瘤外科收治的腹腔镜下直肠癌Dixon手术的老年患者60例,采用随机数字表法分为对照组30例和TAES组30例。两组患者均选择全凭静脉麻醉,TAES组患者麻醉诱导前30 min至术毕加用TAES进行干预。在围术期使用精神状态简易速检表(MMSE)对患者认知功能进行评分,并在不同时间点检测患者血清超氧化物歧化酶(SOD)、丙二醛(MDA)、S100β水平。结果 MMSE评分治疗方法与时间无交互作用(P0.05);组间比较,差异有统计学意义(P0.05);时间间比较,差异有统计学意义(P0.05)。术后1、3、5 d TAES组MMSE评分高于对照组(P0.05)。术后1、3 d TAES组患者POCD严重程度低于对照组(P0.05),术后5、7 d两组患者POCD严重程度比较,差异无统计学意义(P0.05)。SOD、MDA、S100β水平治疗方法与时间无交互作用(P0.05);组间比较,差异有统计学意义(P0.05);时间间比较,差异有统计学意义(P0.05)。术毕,术后2、6、24 h TAES组SOD水平高于对照组(P0.05);术后2、6、24 h TAES组MDA、S100β水平低于对照组(P0.05)。结论老年患者腹腔镜直肠癌切除导致术后认知功能障碍,TAES通过增加SOD水平、抑制MDA聚集、减少S100β释放,保护脑功能,可以明显减少患者术后认知功能障碍的发生。
[Abstract]:Objective to investigate the effect and possible mechanism of percutaneous acupoint electrical stimulation (TAES) on cognitive function after laparoscopic rectal cancer resection in elderly patients. Methods from June 2011 to May 2014, 60 elderly patients undergoing laparoscopic Dixon operation for rectal cancer were selected and divided into control group (n = 30) and TAES group (n = 30) from June 2011 to May 2014. Patients in both groups were treated with TAES 30 min before anesthesia induction. The cognitive function of the patients was evaluated by mental state quick check table (MMSE) during perioperative period, and the level of serum superoxide dismutase (SOD),) malondialdehyde (MDA) (MDA) S100 尾 was measured at different time points. Results there was no interaction between MMSE score and time (P0.05); the difference between groups was statistically significant (P0.05); time comparison, the difference was statistically significant (P0.05). The MMSE score of TAES group was higher than that of control group (P 0.05). The severity of POCD in the TAES group was lower than that in the control group on the 1st and 3rd day after operation (P0.05), and there was no significant difference in the severity of POCD between the two groups on the 7th day after operation (P0.05). There was no interaction between the treatment method and the time (P0.05). The difference was statistically significant (P0.05); time comparison, the difference was statistically significant (P0.05). At the end of operation, the level of SOD in TAES group was higher than that in control group at 24 hours after operation (P0.05), and the MDA,S100 尾 level in TAES group was lower than that in control group at 24 hours after operation (P0.05). Conclusion Laparoscopic resection of rectal cancer can significantly reduce the occurrence of postoperative cognitive dysfunction by increasing the level of SOD, inhibiting the aggregation of MDA, reducing the release of S100 尾 and protecting brain function.
【作者单位】：浙江省温州市中医院麻醉科;温州医科大学附属第一医院麻醉科;
【基金】：国家自然科学基金资助项目(81273926) 国家重点基础研究发展计划973计划(2013CB531900)
【分类号】：R735.37

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