右美托咪定对老年患者术后早期认知功能障碍的影响
发布时间：2019-08-02 11:53
【摘要】：目的观察右美托咪定(DEX)对全麻下老年患者甲状腺癌根治术后早期认知功能障碍(POCD)的影响。方法选择2014年2~5月在该院择期行甲状腺癌根治术患者60例。随机分为DEX组和生理盐水对照组,每组30例。两组患者均采用全凭静脉麻醉,DEX组患者诱导前经静脉输注DEX 0.5μg/kg持续输注10 min,随后0.3μg·kg-1·h-1的速度输注至淋巴结清除结束;对照组以相同方式输注生理盐水。记录两组患者年龄、性别、体重及手术时间;术中输注全麻药总量;分别于术前1 d及术后第1、7天使用简易智能精神状态检查量表(MMSE)进行评分,记录POCD发病率;并分别于麻醉前(T0)、手术结束时(T1)、术后24 h(T2)抽取静脉血,检测血清肿瘤坏死因子(TNF)-α、白细胞介素(IL)-6、IL-10水平。结果与对照组相比,DEX组术中应用丙泊酚及瑞芬太尼的用药量明显减少(P0.05),术后1、7 d的MMSE评分显著提高(P0.05)。患者术后1、7 d两组POCD发病率比较差异均无统计学意义(P0.05)。DEX组患者在手术结束时和术后24 h血清TNF-α、IL-6浓度较对照组明显降低,IL-10明显增高(P0.05)。结论 DEX够有效减少患者术中麻醉药用量,改善甲状腺癌老年患者术后早期认知功能,但不能降低POCD的发生率,其机制可能与DEX能降低炎症因子分泌和增加抗炎因子的释放有关。
[Abstract]:Objective to observe the effect of right metomipramine (DEX) on early cognitive impairment (POCD) in elderly patients under general anesthesia after radical resection of thyroid carcinoma. Methods from February to May 2014, 60 patients with thyroid carcinoma underwent radical thyroidectomy. They were randomly divided into DEX group (n = 30) and saline control group (n = 30). All the patients in the DEX group were anesthetized by intravenous anesthesia. DEX 0.5 渭 g / kg was infused intravenously for 10 min, and then 0.3 渭 g kg- 1 路h-1 until the end of lymph node clearance, while the control group was infused with normal saline in the same way. The age, sex, body weight and operation time of the two groups were recorded, the total amount of general anesthetics was infused during operation, and the incidence of POCD was recorded by (MMSE) on the 1st day before operation and on the 1st and 7th day after operation. Venous blood samples were taken before anesthesia (T0), at the end of operation (T1) and 24 hours after operation (T2) to detect serum tumor necrosis factor (TNF)-伪, IL (IL)-6 and IL 10 levels. Results compared with the control group, the dosage of propofol and remifentanil in DEX group was significantly lower than that in control group (P 0.05), and the MMSE score at 7 d after operation was significantly increased (P 0.05). There was no significant difference in the incidence of POCD between the two groups on the 1st and 7th day after operation (P 0.05). The concentrations of serum TNF- 伪 and IL-6 in the). DEX group were significantly lower than those in the control group at the end of operation and 24 hours after operation, and the IL-10 was significantly higher than that in the control group (P 0.05). Conclusion DEX can effectively reduce the dosage of anesthetics during operation and improve the early cognitive function of elderly patients with thyroid cancer, but it can not reduce the incidence of POCD. The mechanism may be related to DEX can reduce the secretion of inflammatory factors and increase the release of anti-inflammatory factors.
【作者单位】： 吉林大学白求恩第一医院;赤峰市医院麻醉科;
【分类号】：R614
[Abstract]:Objective to observe the effect of right metomipramine (DEX) on early cognitive impairment (POCD) in elderly patients under general anesthesia after radical resection of thyroid carcinoma. Methods from February to May 2014, 60 patients with thyroid carcinoma underwent radical thyroidectomy. They were randomly divided into DEX group (n = 30) and saline control group (n = 30). All the patients in the DEX group were anesthetized by intravenous anesthesia. DEX 0.5 渭 g / kg was infused intravenously for 10 min, and then 0.3 渭 g kg- 1 路h-1 until the end of lymph node clearance, while the control group was infused with normal saline in the same way. The age, sex, body weight and operation time of the two groups were recorded, the total amount of general anesthetics was infused during operation, and the incidence of POCD was recorded by (MMSE) on the 1st day before operation and on the 1st and 7th day after operation. Venous blood samples were taken before anesthesia (T0), at the end of operation (T1) and 24 hours after operation (T2) to detect serum tumor necrosis factor (TNF)-伪, IL (IL)-6 and IL 10 levels. Results compared with the control group, the dosage of propofol and remifentanil in DEX group was significantly lower than that in control group (P 0.05), and the MMSE score at 7 d after operation was significantly increased (P 0.05). There was no significant difference in the incidence of POCD between the two groups on the 1st and 7th day after operation (P 0.05). The concentrations of serum TNF- 伪 and IL-6 in the). DEX group were significantly lower than those in the control group at the end of operation and 24 hours after operation, and the IL-10 was significantly higher than that in the control group (P 0.05). Conclusion DEX can effectively reduce the dosage of anesthetics during operation and improve the early cognitive function of elderly patients with thyroid cancer, but it can not reduce the incidence of POCD. The mechanism may be related to DEX can reduce the secretion of inflammatory factors and increase the release of anti-inflammatory factors.
【作者单位】： 吉林大学白求恩第一医院;赤峰市医院麻醉科;
【分类号】：R614
【共引文献】
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