本文關(guān)鍵詞： 老年食管癌 低劑量 鹽酸戊乙奎醚 腺體分泌 術(shù)后認(rèn)知功能障礙　出處：《重慶醫(yī)學(xué)》2015年08期 　論文類型：期刊論文

【摘要】：目的探討低劑量鹽酸戊乙奎醚對(duì)老年食管癌根除術(shù)患者腺體分泌及早期認(rèn)知的影響。方法 146例擇期行食管癌根除術(shù)老年患者隨機(jī)分成低劑量組和高劑量組,每組73例,麻醉前30min,兩組患者分別采用0.005mg/kg和0.015mg/kg鹽酸戊乙奎醚進(jìn)行靜脈注射。記錄兩組患者手術(shù)情況及術(shù)后認(rèn)知功能障礙(POCD)發(fā)生情況,應(yīng)用視覺模擬評(píng)分法(VAS)對(duì)口干情況進(jìn)行評(píng)價(jià),利用簡易智力狀況檢查法(MMES)定量評(píng)估患者認(rèn)知能力。結(jié)果低劑量組患者術(shù)后POCD發(fā)生率遠(yuǎn)低于高劑量組,差異有統(tǒng)計(jì)學(xué)意義(P0.05),氣道分泌物多于高劑量組,差異有統(tǒng)計(jì)學(xué)意義(P0.05);與術(shù)前比較,兩組患者T1~4時(shí)刻患者口干評(píng)分均明顯升高,差異均有統(tǒng)計(jì)學(xué)意義(P0.05),T1~4時(shí)刻,低劑量組患者口干評(píng)分均低于高劑量組,差異均有統(tǒng)計(jì)學(xué)意義(P0.05);T5和T6時(shí)刻,低劑量組患者M(jìn)MES評(píng)分均高于高劑量組,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論低劑量鹽酸戊乙奎醚應(yīng)用于老年食管癌根除術(shù)患者可以抑制腺體分泌,減少術(shù)后早期POCD發(fā)生,較為安全有效。
[Abstract]:Objective to evaluate the effect of low dose of penehyclidine hydrochloride and the effect of eradication of early postoperative cognitive glands on the secretion of elderly patients with esophageal carcinoma. Methods 146 patients scheduled for esophageal cancer radical resection in elderly patients were randomly divided into low dose group and high dose group, 73 cases in each group, 30min before anesthesia, two groups of patients were collected for intravenous injection and 0.005mg/kg 0.015mg/kg penehyclidine hydrochloride. Two groups were recorded in operation and postoperative cognitive dysfunction (POCD) occurrence, using visual analogue scale (VAS) to evaluate the dry mouth, using the mini mental state examination (MMES). The results of quantitative assessment of cognitive ability in patients with low dose group of patients after POCD were more lower than the high dose group, the difference was statistically significant (P0.05), airway secretions than high dose group, the difference was statistically significant (P0.05); compared with the preoperative, two groups of patients with T1~4 patients with dry mouth moment scores significantly rise High, the differences were statistically significant (P0.05, T1~4), low dose group of patients with xerostomia scores were lower than the high dose group, the differences were statistically significant (P0.05); T5 and T6, the low dose group of MMES patients were higher than that of the high dose group, the differences were statistically significant (P0.05). Conclusion: low dose of amyl ethyl hydrochloride penehyclidine used in elderly esophageal cancer patients with eradication can inhibit glandular secretion, reduce early postoperative POCD, is safe and effective.

【作者單位】： 河南省新鄉(xiāng)市中心醫(yī)院麻醉科;
【分類號(hào)】：R735.1
【正文快照】： 老年食管癌根除術(shù)患者早期易發(fā)生術(shù)后認(rèn)知功能障礙(postoperative cognitive dysfunction,POCD),發(fā)生POCD則會(huì)大大增加患者術(shù)后病死率[1-2],因此,如何有效減少POCD的發(fā)生已成為臨床研究的重點(diǎn)。有研究指出[3],中樞神經(jīng)乙酰膽堿衰退可能與老年P(guān)OCD發(fā)生有關(guān)。鹽酸戊乙奎醚是中國

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