【摘要】：目的老年肺癌根治術(shù)應(yīng)用廣泛,文中探討急性高容量血液稀釋對老年肺癌根治術(shù)患者術(shù)后認知功能、血漿S100β的影響。方法選取華北理工大學附屬醫(yī)院2012年10月至2014年10月老年肺癌根治術(shù)患者112例,采用隨機數(shù)字表法分為2組,稀釋組(56例):患者實施急性高容量血液稀釋。對照組(56例):患者未實施急性高容量血液稀釋。采用簡易精神狀態(tài)量表(mini-mental state examination,MMSE)評定患者的認知功能,比較2組患者T0(麻醉誘導(dǎo)后即刻)、T1(血液稀釋15 min)、T2(血液稀釋60 min)、T3(手術(shù)結(jié)束前60 min)、T4(手術(shù)結(jié)束時)時間點腦氧代謝指標(血氧飽和度、血氧含量差、腦氧攝取率、乳酸差)、血漿S100β,以及術(shù)前、術(shù)后1、3、5、7 d的MMSE評分。結(jié)果 T1、T2、T3、T4時刻的稀釋組患者血氧飽和度分別為(75.1±4.3)%、(78.5±3.1)%、(79.1±4.4)%、(79.6±2.8)%;血氧含量差、腦氧攝取率均隨時間逐漸降低,與T0時刻比較差異均有統(tǒng)計學意義(P0.05);對照組血氧飽和度分別為(63.4±2.0)%、(63.9±1.8)%、(64.2±3.0)%、(64.7±3.2)%,組間同時間點比較,差異均有統(tǒng)計學意義(P0.05);T1、T2、T3、T4時刻的稀釋組患者血漿S100β分別為(0.53±0.04)、(0.52±0.07)、(0.51±0.06)、(0.50±0.08)μg/L,對照組分別為(0.64±0.06)、(0.64±0.04)、(0.65±0.05)、(0.67±0.06)μg/L,組間同時間點比較的差異有統(tǒng)計學意義(P0.05)。術(shù)后1、3、5、7 d,稀釋組MMSE評分分別為(24.3±1.7)、(26.5±1.9)、(27.8±1.3)、(28.1±1.0)分,對照組分別為(21.1±1.6)、(24.0±2.1)、(25.9±1.8)、(26.4±1.7)分,組間同時間點比較,稀釋組MMSE評分均明顯高于對照組(P0.05)。結(jié)論急性高容量血液稀釋可明顯改善老年肺癌根治術(shù)患者術(shù)后認知功能狀況,降低血漿S100β,可能與腦氧代謝有關(guān)。
[Abstract]:Objective to investigate the effect of acute hypervolemic hemodilution on postoperative cognitive function and plasma S100 尾 in elderly patients with lung cancer. Methods 112 elderly patients undergoing radical resection of lung cancer from October 2012 to October 2014 in affiliated Hospital of North China University of Science and Technology were randomly divided into two groups: acute hypervolemic hemodilution was performed in the dilution group (56 cases). Control group (56 cases): acute hypervolemic hemodilution was not performed. Simple mental state scale (mini-mental state examination,MMSE) was used to evaluate the cognitive function of the patients. T0 (immediately after anesthesia induction) T _ 1 (hemodilution 15 min) / T _ 2 (hemodilution 60 min) T _ 3 (60 min before the end of operation) and T _ 4 (at the end of operation) were compared at the time points of cerebral oxygen metabolism (blood oxygen saturation, blood oxygen content difference, cerebral oxygen uptake rate). Lactic acid difference), plasma S 100 尾, and MMSE score of 5 days before and 1 day after operation. Results the blood oxygen saturation was (75.1 鹵4.3), (78.5 鹵3.1), (79.1 鹵4.4), (79.6 鹵2.8) in T _ 1T _ 2T _ 3 T _ 3 T _ 4 dilution group, respectively, and the difference of blood oxygen content and the rate of cerebral oxygen uptake gradually decreased with time, and the blood oxygen saturation was (75.1 鹵4.3), (78.5 鹵3.1), (79.1 鹵4.4), (79.6 鹵2.8), respectively. The blood oxygen saturation of the control group was (63.4 鹵2.0), (63.9 鹵1.8), (64.2 鹵3.0), (64.7 鹵3.2), respectively, and that of the control group was (63.4 鹵2.0), (63.9 鹵1.8), (64.7 鹵3.2), respectively. There were significant differences in plasma S100 尾 between the dilution group (0.53 鹵0.04), (, 0.52 鹵0.07), (, 0.51 鹵0.06), (, 0.50 鹵0.08 渭 g / L) and the control group (0.64 鹵0.06), (, 0.64 鹵0.04), (0.65 鹵0.05), (0.67 鹵0.06) 渭 g / L, respectively (P0.05). The MMSE score of dilution group was (24.3 鹵1.7), (26.5 鹵1.9), (27.8 鹵1.3), (28.1 鹵1.0, and that of control group was (21.1 鹵1.6), (24.0 鹵2.1), (25.9 鹵1.8), (26.4 鹵1.7) at 7 days after operation. The MMSE score of dilution group was significantly higher than that of control group at the same time point (P0.05). Conclusion Acute hypervolemic hemodilution can significantly improve the cognitive function and decrease the plasma S100 尾 in elderly patients with lung cancer after radical resection, which may be related to cerebral oxygen metabolism.
【作者單位】： 華北理工大學附屬醫(yī)院麻醉科;唐山市人民醫(yī)院神經(jīng)內(nèi)科;
【基金】：唐山市科技計劃項目(14130213a)
【分類號】：R614;R734.2

【參考文獻】

相關(guān)期刊論文 前10條

1 張學康;趙為祿;閔佳;戴寒英;;急性高容量血液稀釋聯(lián)合瑞芬太尼控制性降壓對顱內(nèi)動脈瘤術(shù)患者血流動力學和腦氧代謝的影響[J];臨床麻醉學雜志;2012年02期

2 許德兵;宋勇;;分子生物標志物在肺癌早期診斷中的研究進展[J];醫(yī)學研究生學報;2013年07期

3 胡彥艷;秦丹丹;葉鳳青;黃中華;黃愛蘭;馬利;藍嬌;;舒芬太尼復(fù)合氟比洛芬酯PCIA對老年肺癌根治術(shù)患者細胞免疫功能的影響[J];臨床麻醉學雜志;2013年10期

4 關(guān)正;張永健;景桂霞;袁偉;劉t熃，

本文編號：2214012