| 杨春艳,王 晖,宋宇龙,李 扬,马 列.右美托咪定联合乌司他丁对老年胃肠肿瘤切除术患者术后认知功能障碍的影响[J].,2017,17(35):6891-6895 |
| 右美托咪定联合乌司他丁对老年胃肠肿瘤切除术患者术后认知功能障碍的影响 |
| Effects of Dexmedetomidine Combined with Ulinastatin on the Postoperative Cognitive Dysfunction in Elderly Patients with Gastrointestinal Tumor Resection |
| 投稿时间：2017-07-05 修订日期：2017-07-30 |
| DOI：10.13241/j.cnki.pmb.2017.35.021 |
| 中文关键词: 乌司他丁 右美托咪定 老年患者 术后认知功能障碍 安全性 |
| 英文关键词: Ulinastatin Dexmedetomidine Elderly patients Postoperative cognitive dysfunction Safety |
| 基金项目:陕西省社会发展公关项目(2014K11-03-03-06) |
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| 中文摘要: |
| 摘要 目的：探讨右美托咪定联合乌司他丁对老年胃肠肿瘤切除术患者术后认知功能障碍(postoperative cognitive dysfunction，POCD)的影响。方法：选择2013年8月至2016年11月在我院进行胃肠切除术的老年患者90例，随机分为两组，对照组40例患者术中接受右美托咪定麻醉处理，联合组50例患者在对照组基础上泵入乌司他丁。比较两组患者手术前后的血清炎性因子及S-100β水平、简易智能状态量表(mini-mental state examination，MMSE)评分的变化、术后认知功能障碍及不良反应的发生情况。结果：两组患者术后1 d血清肿瘤坏死因子α(TNF-α)、白介素-6(IL-6)及S-100β水平较治疗前均显著升高(P<0.05)，且联合组以上指标均显著低于对照组(P<0.05)，MMSE评分显著高于对照组(P<0.05)。联合组术后7 d POCD、高血压的发生率及不良反应发生率均显著低于对照组(P<0.05)。结论：右美托咪定联合乌司他丁用于老年胃肠肿瘤切除术可有效控制患者手术后炎症反应，改善患者认知功能障碍，且安全性较好。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the effect of dexmedetomidine combined with ulinastatin on the postoperative cognitive dys- function (POCD) in elderly patients with gastrointestinal tumorresection. Methods: 90 cases of patients with gastrointestinal tumor resec- tion in our hospital from August 2013 to December 2016were selected and randomly divided into two groups, the control group (n=40) was treated by dexmedetomidine during in the operation, and combined group (n=50) was treated by ulinastatin based on the control group. The serum inflammatory factors and S-100β levels, mini-mental state examination (MMSE) score of two groups before and after operation, incidence of postoperative cognitive dysfunction and adverse reactions were compared between two groups. Results: On the 1st day postoperation, the serum levels of tumor necrosis factor-α (TNF-α), interleukin -6 (IL-6) and S-100β of both groups were signifi- cantly increased compared with pre-treatment (P<0.05), which were obviously lower in the combined group than those of the control group(P<0.05). The MMSE score of combined group on the 1st day postoperation was higher than that of the control group(P<0.05). The incidence of POCD in the combined group during 7 days postoperation was lower than that of the control group (P<0.05). The incidence of hypertension and total incidence of adverse reactions of combined group were lower than those of the control group (P<0.05). Conclusion: Dexmedetomidine combined with ulinastatin can effectively control the inflammatory response postoperation and improve the POCD with high safety in the treatment of elderly patients with gastrointestinal tumor resection. |
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