右美托咪定对胸腔镜食管癌根治术老年患者认知功能及血清炎症因子、神经损伤标志物水平的影响

发布时间：2018-02-15 04:40

本文关键词： 右美托咪定认知功能炎症因子神经损伤标志物老年人食管癌根治术胸腔镜手术麻醉　出处：《山东医药》2017年23期 　论文类型：期刊论文

【摘要】：目的探讨全麻气管插管后静脉泵入右美托咪定对胸腔镜食管癌根治术老年患者术后认知功能及血清炎症因子、神经损伤标志物水平的影响。方法将80例接受胸腔镜食管癌根治术治疗的老年患者随机分为右美托咪定组和对照组,各40例。两组采用单腔气管插管下静脉麻醉,右美托咪定组全麻气管插管后静脉泵入右美托咪定,对照组组静脉泵入等量生理盐水。于麻醉开始前(T_1)、手术结束时(T_2)、术后1天(T_3)、术后3天(T_4)取患者静脉血检测血清炎症因子肿瘤坏死因子(TNF-α)、白细胞介素1β(IL-1β)及血清神经损伤标志物S100β、神经特异性烯醇化酶(NSE)水平。于T_1、T_3、T_4时间点采用简易智力状态检查法(MMSE)评估患者认知功能。结果与T_1相比,T_2、T_3两组患者血清S100β、NSE水平上升(P均0.01),T_2、T_3、T_4两组患者血清TNF-α、IL-1β水平上升(P均0.01)。与对照组相比,右美托咪定组患者T_2、T_3时间点血清S100β、NSE水平较低(P均0.01),T_2、T_3、T_4时间点血清TNF-α、IL-1β水平较低(P均0.01)。与T_1相比,T_3、T_4两组患者MMSE评分下降(P均0.01);与对照组相比,右美托咪定组患者T_3、T_4时间点MMSE评分较高(P均0.01)。结论全麻气管插管后静脉泵入右美托咪定可以减轻老年患者胸腔镜人工气胸下食管癌根治术后认知功能下降,降低血清S100β、NSE、TNF-α、IL-1β水平。
[Abstract]:Objective to investigate the effects of intravenous infusion of dexmetomidine on postoperative cognitive function and serum inflammatory factors in elderly patients undergoing thoracoscopic radical resection of esophageal cancer after general anesthesia. Methods 80 elderly patients undergoing thoracoscopic radical resection of esophageal cancer were randomly divided into dexmetomidine group and control group, 40 patients in each group were anesthetized by single lumen endotracheal intubation, the two groups were randomly divided into two groups: dexmetomidine group (n = 40) and control group (n = 40). Dexmetomidine group received intravenous infusion of dexmetomidine after tracheal intubation under general anesthesia. The control group was injected with the same amount of normal saline. Before the anesthesia began, the patients were given T _ (1). After operation, the patients were given T2P, 1 day after operation, 3 days after operation, and 3 days after operation.) the venous blood samples of the patients were taken to detect the levels of inflammatory factor tumor necrosis factor TNF- 伪, interleukin-1 尾 and IL-1 尾) and the nerve in serum. The level of S100 尾, neuro-specific enolase (NSE). The cognitive function of patients was evaluated by MMSEE at T _ 1 / T _ 3T _ 4 at T _ 1 / T _ 3T _ 4. Results compared with T _ 1, T _ (2) T _ (2) T _ (2) T _ (3) increased the serum S100 尾 -NSE level (P = 0.01) and T _ (2) T _ (2) T _ (+) T _ 3 / T _ 4 levels increased in both groups. The serum levels of TNF- 伪 and IL-1 尾 were increased by 0.01 渭 g / L, and compared with those in the control group. The serum S100 尾 -NSE level of patients in the right metoimidine group was lower than that of the patients in the control group at the time of T _ 2C _ 2 / T _ 3 (P < 0.01). The serum levels of TNF- 伪 and IL-1 尾 were lower than those in the T _ 1 + T _ 1 + T _ 3T _ 3 group, and the MMSE scores of the patients in the two groups were lower than those in the control group (P < 0.01), and compared with those in the control group, the levels of serum TNF- 伪 and IL-1 尾 were lower than those in the control group. Conclusion intravenous infusion of dexmetomidine after tracheal intubation can alleviate the decrease of cognitive function and decrease the level of serum S100 尾 -NSENSE- 伪 and IL-1 尾 after radical resection of esophageal carcinoma under thoracoscopic pneumothorax in patients with dexmetomidine.
【作者单位】：四川省肿瘤医院;沈阳体育学院运动人体科学学院;
【基金】：国家自然科学基金项目(81171034)
【分类号】：R614;R735.1

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