贫血对女性腹腔镜手术患者术后认知功能的影响

发布时间：2018-04-04 04:42

本文选题：术后认知功能障碍　切入点：贫血　出处：《实用医学杂志》2017年16期

【摘要】：目的探讨不同程度的贫血对腹腔镜手术后女性患者认知功能的影响。方法选取2016年1-12月实行腹腔镜下子宫肌瘤剔除术或全子宫切除术的女性患者215例,根据其术前血红蛋白含量分成正常(N组)、轻度贫血(A组)、中度贫血(B组)3组。所有患者均采用相同的麻醉和复苏方案。记录患者基础及麻醉手术情况。分析各组患者术前、术后1、5、30 d的蒙特利尔认知测试(Montreal cognitive assessment,MoCA)评分差异,比较其术前及术后1 d的血清S-100β和IL-6水平变化。结果各组患者基础情况及麻醉手术情况差异均无显著性。与N组相比,B组术后苏醒时间延长。3组患者术前和术后30 d的MoCA评分差异均无显著性。与N组相比,A组患者MoCA评分差异无显著性,B组患者术后第1天和第5天的MoCA评分明显降低。与N组相比,A组患者术后POCD发生率差异均无显著性,B组患者术后3个时间点的POCD发生率升高。术前3组血清S-100β和IL-6水平差异均无显著性。3组患者血清S-100β含量和IL-6水平均较术前升高。与N组相比,A组和B组术后1 d血清S-100β和IL-6含量升高。与A组相比,B组术后1 d血清S-100β和IL-6含量升高。结论中度贫血女性患者较易发生术后早期认知功能下降,其可能与术中过度炎症反应介导的中枢神经损伤相关。
[Abstract]:Objective to investigate the effect of anemia on cognitive function of female patients after laparoscopic surgery.Methods 215 women who underwent laparoscopic hysteromyomectomy or total hysterectomy from January to December 2016 were divided into 3 groups according to their preoperative hemoglobin content: normal group, mild anemia group A, moderate anemia group B group.All patients were treated with the same anesthesia and resuscitation regimen.Record the patient's basic and anesthetic operation.To analyze the difference of Montreal cognitive assessments-MoCA score between the patients before operation and 30 days after operation, and to compare the changes of serum S-100 尾 and IL-6 levels before and 1 day after operation.Results there was no significant difference in basic condition and anesthetic operation in each group.There was no significant difference in MoCA score between group B and group N before operation and 30 days after operation.There was no significant difference in MoCA score between group A and group N, and the MoCA score of group B was significantly lower on the 1st and 5th day after operation.There was no significant difference between group A and group N in the incidence of postoperative POCD. The incidence of POCD in group B was significantly higher than that in group B.There was no significant difference in serum S-100 尾 and IL-6 levels among the three groups before operation. The levels of S-100 尾 and IL-6 in the three groups were higher than those before operation.Compared with group N, serum S-100 尾 and IL-6 levels in group A and group B increased 1 day after operation.Compared with group A, serum S-100 尾 and IL-6 levels in group B increased 1 day after operation.Conclusion moderate anemia women are more prone to early postoperative cognitive impairment, which may be related to the injury of central nervous system mediated by excessive inflammatory reaction during operation.
【作者单位】：广东省妇幼保健院麻醉科;
【基金】：广东省中医药局面上科研立项项目(编号:20172018)
【分类号】：R614

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