【摘要】 目的研究老年患者行食管癌根治术过程中应用右美托咪定对其早期认知功能和血清炎症因子水平的影响。方法选取2018-02—2019-02在郑州大学第二附属医院接受食管癌根治术的80例老年患者进行研究,随机分为试验组和对照组各40例。在全麻双腔支气管插管后,试验组静脉泵注右美托咪定,对照组静脉泵入等量生理盐水。采用简易智力状态检查法(MMSE)对2组老年患者在麻醉开始前(T1)、手术结束后第1天(T3)、手术结束后第3天(T4)的认知功能进行评价,同时记录T1、手术结束时(T2)、T3、T4时的炎症因子[肿瘤坏死因子(TNF-α)、血清白细胞介素-1β(IL-1β)]以及血清神经生物学标志物(S100β)和神经特异性烯醇化酶(NSE)。结果与T1时间点相比,2组在T3、T4时间点的MMSE评分降低(P<0.05)。与对照组相比,试验组在T3、T4时间点的MMSE评分增高(P<0.05);与T1时间点相比,2组在T2、T3、T4时间点的TNF-α、IL-1β水平均增高(P<0.05),与对照组相比,试验组在T2、T3、T4时间点的TNF-α、IL-1β水平均降低(P<0.05);与T1时间点相比,2组在T2、T3时间点的S100β和NSE水平均增高(P<0.05),与对照组相比,试验组在T2、T3时间点的S100β和NSE水平均降低(P<0.05)。结论全麻插管后静脉泵入右美托咪定,不仅可有效减轻老年食管癌患者术后的认知功能下降水平,还可降低炎症因子和血清S100β、NSE水平。更多还原

【Abstract】 Objective To study the clinical effects of Dexmedetomidine on early cognitive function and level of serum inflammatory factor in patients with esophageal cancer.Methods From February 2018 to February 2019,80 patients undergoing radical esophageal carcinoma in our hospital were randomly divided into two groups:the experimental group(n=40)and the control group(n=40).After double lumen endobronchial intubation under general anesthesia,the experimental group received intravenous infusion of dexmedetomidine.In the control group,the same amount of nomal saline was injected intravenously.The cognitive function of the two groups of elderly patients was evaluated by MMSE before the start of anesthesia(T1),1 day after operation(T3)and 3 days after operation(T4).The inflammatory factors(tumor necrosis factor(TNF-α),serum interleukin1β(IL-1β)),serum neurobiological markers(S100β)and neurospecific enolase(NSE) were recorded at T1,the end of operation(T2),T3,T4.Results Compared with T1 time point,MMSE scores at T3,T4 time point were lower in two groups(P<0.05).Compared with control group,the MMSE scores at T3,T4 time point in experimental group were higher(P<0.05).Compared with T1 time point,the levels of TNF-α and IL-1β at T2,T3,T4 time point were higher in two groups(P<0.05).Compared with control group,The levels of TNF-α and IL1-β at T2,T3,T4 time point were lower in the experimental group(P<0.05).Compared with T1 time point,the level of S100β and NSE of T2,T3 were higher in two group(P<0.05).Compared with control group,the levels of S100β and NSE at T2,T3 time point were lower in the experimental group(P<0.05).Conclusion Dexmedetomidine was pumped by intravenous infusion after general anesthesia,that not only reduced levels of cognitive decline,but also reduced the level of inflammatory factor and S100β,NSE.更多还原