乌司他丁对老年患者胸腔镜辅助肺叶切除术后认知功能障碍的影响

发布时间：2018-04-10 10:25

本文选题：乌司他丁　+ 老年人　引自：《广东医学》2017年03期

【摘要】：目的观察乌司他丁对老年患者胸腔镜辅助肺叶切除术后认知功能障碍(POCD)的影响。方法拟行胸腔镜辅助肺叶切除术的老年患者60例,随机分为观察组和对照组,每组30例,观察组在麻醉诱导前静脉注射乌司他丁20万U,然后以10万U/h的速度持续静脉泵注射至患者离室,对照组给予等剂量的生理盐水。测定患者手术前1 d(T0)、手术结束时(T1)、手术后第1天(T2)和手术后第3天(T3)血浆白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)的浓度,并在T0、T2、T3时点完成简易精神状态检查量表(MMSE)评分,记录POCD发生率。结果观察组T1、T2时点IL-6和TNF-α水平低于对照组(P0.05),两组T1时点IL-6和TNF-α水平高于其他时点(P0.05),对照组T2时点IL-6和TNF-α水平高于T0、T3(P0.05)。观察组T2时点MMSE评分高于对照组(P0.05),对照组T2时点MMSE评分低于T0、T3(P0.05)。POCD发生率观察组低于对照组(P0.05)。结论乌司他丁降低老年患者胸腔镜辅助肺叶切除术后血浆IL-6和TNF-α水平,减少POCD的发生。
[Abstract]:Objective to observe the effect of ulinastatin on cognitive impairment (POCD) after thoracoscopic assisted lobectomy in elderly patients.Methods Sixty elderly patients with thoracoscopic assisted lobectomy were randomly divided into observation group (n = 30) and control group (n = 30).Ulinastatin was injected intravenously at a rate of 100000 Uh before anesthesia induction in the observation group. The patients in the control group were given the same dose of normal saline at the rate of 100000 Uh.The incidence of POCD was recorded.Results the levels of IL-6 and TNF- 伪 at T _ 1 and T _ 2 in the observation group were lower than those in the control group (P 0.05), the levels of IL-6 and TNF- 伪 at T _ 1 were higher than those in other time points (P 0.05), and the levels of IL-6 and TNF- 伪 at T _ 2 in the control group were higher than those in the control group.Conclusion ulinastatin can reduce the levels of plasma IL-6 and TNF- 伪 and decrease the incidence of POCD in elderly patients after thoracoscopic assisted lobectomy.
【作者单位】：暨南大学医学院第二附属医院深圳市人民医院麻醉科深圳市麻醉医学工程研究中心;
【基金】：深圳市科技计划项目(编号:JCYJ20140416122812032)
【分类号】：R614.24

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