| 宋丽华,高艳平,朱 江,陈 璐,朱 洁.右美托咪啶联合布托啡诺对老年腹腔镜胃肠肿瘤根治术术后认知功能障碍的影响[J].,2019,19(21):4157-4160 |
| 右美托咪啶联合布托啡诺对老年腹腔镜胃肠肿瘤根治术术后认知功能障碍的影响 |
| Effect of Dexmedetomidine Combined with Butorphanol on the Cognitive Dysfunction after Gastrointestinal Tumors Laparoscopic Radicalin in the Elderly Patients |
| 投稿时间：2019-02-27 修订日期：2019-03-23 |
| DOI：10.13241/j.cnki.pmb.2019.21.035 |
| 中文关键词: 右美托咪啶 布托啡诺 腹腔镜 老年胃肠肿瘤根治术 术后认知功能障碍 |
| 英文关键词: Dexmedetomidine Butorphanol Laparoscopic Gastrointestinal tumors radicalin in elderly patients Postoperative cognitive impairment |
| 基金项目:江苏省自然科学基金项目(2015J0316) |
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| 中文摘要: |
| 摘要 目的：探究右美托咪啶联合布托啡诺对老年腹腔镜胃肠肿瘤根治术术后认知功能障碍的影响。方法：选取2015年8月~2018年9月在我院行腹腔镜胃肠肿瘤根治术的老年患者80例进行回顾性分析，根据术前用药情况不同分为两组，观察组术前给予右美托咪啶联合布托啡诺，对照组术前给予等量生理盐水。比较两组患者的Ramsay镇静评分、术前和术后不同时间点认知功能评分、血清S-100β蛋白(S-100β protein，S-100β)、神经元特异性烯醇酶(Neuron-specific enolase，NSE)和白介素-6(Interleukin-6，IL-6)水平的变化及不良反应的发生情况。结果：观察组患者拔管时、拔管后4 h、拔管后8 h和拔管后12 h的Ramsay镇静评分显著优于对照组(P<0.05)。两组患者手术前1d(T0)时简易智能精神状态检查量表(mini-mental state examination，MMSE)各项评分及总分相比均无统计学差异(P＞0.05)，观察组手术后1d(T1)和手术后2d(T2)时MMSE各项评分及总分均显著高于对照组(P＜0.05)。观察组患者T1时血清S-100β和IL-6水平显著低于对照组，T1和T2时血清NSE水平均显著低于对照组(P＜0.05)。两组患者恶心、呕吐、嗜睡和头晕的发生率相比均无统计学差异(P＞0.05)。结论：老年腹腔镜胃肠肿瘤根治术术前应用右美托咪啶联合布托啡诺可显著改善患者的术后认知功能，提高麻醉效果，且不增加并发症的发生率。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effect of dexmedetomidine combined with butorphanol on cognitive dysfunction after gastrointestinal tumors laparoscopic radicalin elderly patients. Methods: 80 elderly patients who underwent laparoscopic radical for gastrointestinal tumors in our hospital from August 2015 to September 2018 were selected for retrospective analysis. According to the different preoperative drug use, they were divided into two groups. The observation group was given dexmedetomidine combined with butofenol preoperatively, and the control group was given the same amount of normal saline preoperatively. Ramsay sedative score, Ramsay sedative score, preoperative and postoperative cognitive function score, S-100β, NSE and IL-6 levels and adverse reactions were compared between the two groups. Results: The Ramsay sedative score of patients in the observation group was significantly better than that in the control group (P<0.05) at the time of extubation, at 4h, 8h and 12h after extubation. There was no statistically significant difference in the MMSE score and total score between the two groups at T0 before surgery(P>0.05). The MMSE scores and total scores in the observation group at T1 and T2 were significantly higher than those in the control group (P<0.05). At T1, the serum levels of S-100β and IL-6 in the observation group were significantly lower than those in the control group, and serum NSE levels at T1 and T2 were significantly lower than those in the control group (P<0.05). There was no statistically significant difference in the incidence of nausea, vomiting, drowsiness and dizziness between the two groups (P>0.05). Conclusion: The application of dexmedetomidine combined with butorphanol before laparoscopic radical can significantly improve the postoperative cognitive function, anesthesia effect for the elderly patients with gastrointestinal tumors, and it won't increase the incidence of complications. |
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