【摘要】 目的研究靶控输注不同浓度丙泊酚对老年胃癌患者术后认知功能影响。方法选取牡丹江第二医院普外科120例全身麻醉下行胃癌根治术患者,男68例、女52例,随机数字表法分为:P1组(2.5μg/m L)、P2组(3.5μg/m L)、P3组(5μg/m L)和对照组(S组)各30例。麻醉诱导前(T1)、术后6h(T2)、1d(T3)、3d(T4)采静脉血5m L,酶联免疫吸附试验法检测IL-6、IL-17A、Aβ1-42蛋白血清含量。在术前1d(T0)、术后1d(T3)、3d(T4)、7d(T5)由同一医师用MMSE量表和MOCA量表检测认知功能。结果与T1时间点比四组患者T2~T4时间点的IL-6、IL-17A均增高P<0.05;Aβ1-42在T3、T4时间点增高P<0.05,同时伴有MOCA评分和MMSE评分均降低;与S组比P1~P3组IL-6、IL-17A、Aβ1-42在T2~T4时间点均降低P<0.05,T3~T5时间点的MOCA评分和MMSE评分均增高P<0.05;与P3组比P1、P2组IL-6和Aβ1-42在T3、T4时间点均降低P<0.05,IL-17A在T2~T4时间点均降低P<0.05,同时伴有MOCA评分、MMSE评分均增高和POCD发生率降低,差异都具有统计学意义。结论靶控输注丙泊酚2.5μg/m L和3.5μg/m L有利于降低老年胃癌患者POCD发生率。更多还原

【Abstract】 Objective To study the effect of target controlled infusion of different concentrations of propofol on postoperative cognitive function in elderly patients with gastric cancer. Methods 120 cases of radical gastrectomy under general anesthesia were selected in Department of general surgery, Mudanjiang second hospital, male 68 and female 52, there were divided into 4 groups with random number table method, P1 group(2.5μg/m L)、P2 group(3.5μg/m L)、P3 group(5μg/m L) and control group(S group), each group 30 cases. Before anesthesia induction(T1), postoperative 6 h(T2), 1 D(T3), 3 D(T4) vein blood 5 m L, enzyme linked immunosorbent assay was used to detect serum levels of IL-6, IL-17 A and A β1-42 protein. Preoperative 1 d(T0), postoperative 1 d(T3), 3 d(T4) and 7 d(T5), Cognitive function was measured by MMSE scale and MOCA scale in the same doctor. Result Compared with the T1 time point, the IL-6 and IL-17 A of the patients in the four groups at T2 to T4 time points increased, P<0.05; Aβ1-42 increased at T3 and T4 time points, P<0.05, MOCA score and MMSE score were both decreased; Compared with group S, the levels of IL-6, IL-17 A and A beta 1-42 in P1 ~ P3 group were decreased at T2 to T4 time points, P<0.05, the MOCA score and MMSE score at T3 to T5 were higher than those of P<0.05; Compared with group P3, IL-6 and A beta 1-42 decreased at T3 and T4 in group P1 and P2, P<0.05, IL-17 A decreased at T2 to T4 time points, P<0.05, The differences were statistically significant. Conclusion Target controlled infusion of propofol at 2.5 g/m L and 3.5 g/m L is beneficial to reduce the incidence of POCD in elderly patients with gastric cancer.更多还原