【摘要】 目的 探讨不同麻醉方式对老年肺癌根治术患者认知功能及炎症细胞因子表达的影响。方法 将88例老年肺癌行根治术患者按随机数字表法分为观察组45例和对照组43例,观察组采用七氟醚吸入麻醉,对照组采用丙泊酚注射液静脉麻醉,记录肺癌根治术临床治疗情况,手术前后采用简易智能精神状态检查量表评定认知功能状况,采用酶联免疫吸附法检测血清炎症细胞因子水平变化,随时记录治疗过程中出现的不良反应发生状况。结果 观察组手术时间显著短于对照组,苏醒时间、拔管时间、恢复自主呼吸时间显著早于对照组(P<0.01);手术后两组简易智能精神状态检查量表各维度评分均较手术前显著下降(P<0.01),但观察组各维度评分均显著高于对照组(P<0.01);两组炎症细胞因子各项指标水平均较手术前显著升高(P<0.01),但观察组各项指标水平均显著低于对照组(P<0.01);观察组不良反应发生率(13.33%)显著低于对照组(32.56%)(P<0.05)。结论 七氟醚吸入麻醉对老年肺癌患者根治术早期认知功能和炎症细胞因子水平的调节具有积极促进作用,安全性高,具有临床应用价值。更多还原

【Abstract】 Objective To investigate the effect of different anesthetic techniques on cognitive function and inflammatory cytokine expression in elderly patients with lung cancer. Methods 88 elderly patients with lung cancer radical surgery randomly divided into observation group(n = 45) and control group(n= 43).The patients in observation group were treated with sevoflurane inhalation anesthesia. The patients in control group were treated with propofol intravenous anesthesia. The clinical treatment conditions of the two groups were recorded. The MMSE and ELISA were used to evaluate the cognitive function condition, serum inflammatory cytokine level changes before and after treatment, the adverse reactions during the treatment were recorded in time. Results Compared with the control group, the awakening time, extubation time, spontaneous breathing recover time in the observation group were significantly earlier(P<0. 01),after operation, each scores of MMSE in the two groups after operation were significantly declined(P <0.01), and each scores in the observation group were significantly higher than those in the control group(P<0. 01); each indexes levels of inflammatory cytokine were significantly improved after operation(P<0. 01), and each indexes levels in the observation group were significantly lower than those in the control group(P<0. 01); the adverse reaction rate in the observation group was significantly lower than that in the control group(32. 56%)(P<0. 05). Conclusions Sevoflurane inhalation anesthesia has a positive role in promoting the regulation of cognitive function and inflammatory cytokine level in elderly patients with lung cancer radical surgery, it has higher safety and is worthy of clinical application.更多还原