摘要
目的探讨右美托咪定辅助全身麻醉对老年妇科腹腔镜手术患者术后炎症反应和认知功能障碍的影响。方法选择2018—2019年择期行妇科腹腔镜全子宫切除手术的老年子宫脱垂Ⅲ度90例,根据是否应用右美托咪定辅助全身麻醉将其分为观察组和对照组两组各45例。观察组应用右美托咪定辅助全身麻醉,对照组未应用右美托咪定辅助全身麻醉。比较两组不同时间点心率、平均动脉压和血糖水平,手术前后血清炎性因子和S100-β蛋白水平,以及手术前后认知功能障碍情况。结果与麻醉诱导前比较,插管即刻(T1)、插管后5 min(T2)、手术结束时(T3)、拔管即刻(T4)、拔管后5 min(T5)和拔管后1 h(T6)时两组心率和平均动脉压均降低,血糖均升高;T1~T6时,观察组心率、平均动脉压和血糖水平均低于对照组,差异有统计学意义(P<0.05或P<0.01)。与术前24 h比较,术后24和72 h两组血清白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)和S100-β蛋白水平均升高;术后24和72 h,观察组血清IL-6、IL-10、TNF-α和S100-β蛋白水平低于对照组,差异有统计学意义(P<0.05或P<0.01)。与术前24 h比较,术后6、24和72 h两组简易智能精神状态检查(MMSE)量表评分均下降;术后6、24和72 h,观察组MMSE量表评分高于对照组,差异有统计学意义(P<0.01)。术后72 h,观察组认知功能障碍发生率低于对照组,差异有统计学意义(P<0.05)。结论右美托咪定辅助全身麻醉可改善老年妇科腹腔镜手术患者术后认知功能障碍,可能与炎症反应减轻有关。
Objective To explore effects of Dexmedetomidine-assisted general anesthesia on postoperative inflammatory responses and cognitive dysfunction in elderly patients undergoing gynecological laparoscopic surgery.Methods Ninety elderly patients with third degree uterine prolapse who had undergone elective laparoscopic total hysterectomy from 2018 to 2019 were divided into observation group(n=45)and control group(n=45)according to application of Dexmedetomidine assisted general anesthesia.Observation group was given Dexmedetomidine assisted general anesthesia,while control group was not given Dexmedetomidine assisted general anesthesia.Levels of heart rate(HR),mean arterial pressure(MAP)and blood glucose at different time points,serum inflammatory factors and S100-βprotein levels and conditions of cognitive dysfunction before and after surgery were compared in two groups.Results Compared with those before induction of anesthesia(T0),HR and MAP levels were decreased,while levels of blood glucose were increased in two groups at immediately after intubation(T1),at the 5 th min after intubation(T2),at the end of surgery(T3),at immediately after extubation(T4),at the 5 th min after extubation(T5)and in the 1 st h after extubation(T6).levels of HR,MAP and blood sugar in observation group at T1-T6 were significantly lower than those in control group(P<0.05 or P<0.01).In the 24 th h and 72 th h after surgery,serum levels of interleukin-6(IL-6),interleukin-10(IL-10),tumor necrosis factor-α(TNF-α)and S100-βprotein were significantly increased compared with those in the 24 th h before surgery in two groups;serum levels of IL-6,IL-10,TNF-αand S100-βprotein in observation group were significantly lower than those in control group(P<0.05 or P<0.01).In the 6 th h,24 th h and 72 th h after surgery,American Mini Mental State Examination Scale(MMSE)scores were significantly lower compared with those in the 24 th h before surgery in two groups;the MMSE scores in observation group were significantly higher than those in control grou
作者
刘叶
李红
刘枝
毛慧敏
李国芳
李腾
陈红转
闫静
LIU Ye;LI Hong;LIU Zhi;MAO Hui-min;LI Guo-fang;LI Teng;CHEN Hong-zhuan;YAN Jing(Department of Anesthesiology,the Fourth Hospital of Shijiazhuang CityObstetrics and Gynecology Hospital Affiliated to Hebei Medical University,Shijiazhuang 050000,China;Out-patient Operating Room,the Fourth Hospital of Shijiazhuang CityObstetrics and Gynecology Hospital Affiliated to Hebei Medical University,Shijiazhuang 050000,China)
出处
《临床误诊误治》
CAS
2021年第5期96-101,共6页
Clinical Misdiagnosis & Mistherapy
基金
河北省医学科学研究重点课题计划项目(20170992)
石家庄市科学技术研究与发展指导计划项目(181460473)。
