本文選題：譫妄 + 中性粒細(xì)胞明膠酶相關(guān)脂質(zhì)運(yùn)載蛋白�。� 參考：《中國內(nèi)鏡雜志》2017年09期

【摘要】：目的探討血清中性粒細(xì)胞明膠酶相關(guān)脂質(zhì)運(yùn)載蛋白(NGAL)與S-100β蛋白對(duì)婦科腫瘤患者腹腔鏡術(shù)后譫妄(POD)的預(yù)測(cè)效果。方法選取2015年3月-2016年6月該院收治的256例行腹腔鏡全麻手術(shù)的婦科腫瘤患者為研究對(duì)象,根據(jù)術(shù)后狀況分為POD組(n=31)和非POD組(n=225)。比較兩組的全麻前5 min、氣管拔管即刻、出麻醉后監(jiān)測(cè)治療室(PACU)前、術(shù)后24、48和72 h的血清NGAL、S-100β蛋白、肌酐(Scr)和胱抑素C(Cys-c)的水平。采用受試者工作曲線下面積(AUC)來評(píng)價(jià)各指標(biāo)對(duì)POD的預(yù)測(cè)效果。結(jié)果兩組全麻后的血清NGAL與S-100β的水平均明顯高于全麻前,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。POD組的氣管拔管即刻、出PACU前、術(shù)后24 h的血清NGAL水平明顯高于非POD組,差異有統(tǒng)計(jì)學(xué)意義(P0.05);POD組的氣管拔管即刻、出PACU前、術(shù)后24、48和72 h的血清S-100β水平明顯高于非POD組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。全部患者術(shù)后均未出現(xiàn)急性腎損傷(AKI),兩組不同時(shí)間點(diǎn)的血清Scr與Cys-C水平比較,差異均無統(tǒng)計(jì)學(xué)意義(P0.05)。氣管拔管即刻、出PACU前、術(shù)后24 h的血清NGAL與S-100β的AUC分別為0.75、0.77、0.66和0.85、0.83、0.80(P0.05)。結(jié)論血清NGAL和S-100β水平可作為婦科腫瘤患者腹腔鏡術(shù)后譫妄的早期預(yù)測(cè)指標(biāo),且后者的預(yù)測(cè)效果更加好,尤其是氣管拔管即刻與出PACU前。
[Abstract]:Objective to investigate the predictive effect of serum neutrophil gelatinase-associated lipid carrier protein (NGALs) and S-100 尾 protein on delirium POD in patients with gynecological neoplasms after laparoscopic surgery. Methods from March 2015 to June 2016, 256 patients with gynecologic neoplasms undergoing laparoscopic general anesthesia were divided into two groups: POD group (n = 31) and non-POD group (n = 225). The serum levels of NGALS-100 尾, creatinine Scr) and cystatin Cys-c were compared between the two groups 5 min before general anesthesia, 5 min before tracheal extubation, 24 h after anesthesia, 24 h after operation, and 72 h after the extubation of PACUU, and the serum levels of NGALS-100 尾, creatinine (creatinine) and cystatin Cys-c (Cys-c) were measured. The area under the operating curve was used to evaluate the predictive effect of each index on POD. Results the levels of serum NGAL and S-100 尾 in the two groups after general anesthesia were significantly higher than those before general anesthesia, and the difference was statistically significant. The serum NGAL levels were significantly higher in the P0.05U 路POD group than in the non-POD group at 24 hours before and 24 hours after PACU extubation. The serum S-100 尾 levels in the P0.05 / POD group were significantly higher than those in the non-POD group (P 0.05) immediately after tracheal extubation and 24 h and 72 h after PACU, and the difference was statistically significant (P 0.05). No acute renal injury was found in all the patients. There was no significant difference in serum Scr and Cys-C levels between the two groups at different time points (P 0.05). Immediately after tracheal extubation, 24 hours after PACU, the AUC of serum NGAL and S-100 尾 were 0.75U 0.77U 0.66 and 0.85U 0.83U 0.80 P0.05, respectively. Conclusion Serum levels of NGAL and S-100 尾 can be used as early predictors of delirium in patients with gynecological neoplasms after laparoscopic surgery, and the latter is more effective in predicting delirium, especially immediately after tracheal extubation and before PACU.
【作者單位】： 華中科技大學(xué)同濟(jì)醫(yī)學(xué)院附屬武漢中心醫(yī)院婦科;
【分類號(hào)】：R737.3

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