【摘要】：目的目前臨床上缺乏術后認知功能障礙(postoperative cognitive dysfunction,POCD)客觀的診斷方法。文中通過比較丙泊酚及依托咪酯麻醉對患兒術后早期認知功能及血清S100β蛋白水平的影響,探討其間相關性。方法收集桂林醫(yī)學院附屬醫(yī)院2013年7月至2014年11月1~3歲行腹腔鏡下疝修補術患兒的病例資料。排除既往有系統(tǒng)疾病、術后發(fā)生并發(fā)癥等任何影響認知功能評估或不能配合完成全程測試的患兒。將最終納入的100例資料采用單純隨機法分為丙泊酚麻醉組(丙泊酚組)和依托咪酯麻醉組(依托咪酯組)各50例。2組患兒均于術前1 d及術后3 d采用貝莉嬰患兒認知量表Ⅲ按月齡進行相應年齡段的認知功能評估,并均按照Z計分法進行POCD診斷。根據(jù)患兒是否發(fā)生POCD將每組進一步分為POCD和NPOCD 2個亞組。同時丙泊酚組和依托咪酯組患兒分別于術前(T0)、出麻醉恢復室前(T1)抽取髂內(nèi)靜脈血5 m L,酶聯(lián)免疫吸附法檢測血清S100β蛋白濃度;比較2組組內(nèi)及組間POCD和NPOCD患兒血清S100β蛋白水平的改變。結(jié)果1丙泊酚組和依托咪酯組術后3 d分別有10(20.0%)和9(18.0%)名患兒發(fā)生POCD,組間POCD發(fā)生率比較差異無統(tǒng)計學意義(P0.05);2與T0比較,2組患兒T1時血清S100β蛋白含量均升高,差異有統(tǒng)計學意義(P0.05);與NPOCD患兒比較,2組POCD患兒血清S100β蛋白含量均明顯升高,差異有統(tǒng)計學意義(P0.05);組間比較,T1時NPOCD患兒和POCD患兒血清S100β蛋白含量差異均無統(tǒng)計學意義(P0.05);3丙泊酚組與依托咪酯組患兒術畢血清S100β蛋白含量與術后3 d發(fā)生POCD相關(r=0.842,P=0.001;r=0.821,P=0.001)。結(jié)論丙泊酚或依托咪酯麻醉后可引起1~3歲患兒術后出現(xiàn)不同程度的認知功能下降�；純郝樽砗笱錝100β蛋白含量升高與術后早期發(fā)生POCD具有正相關性,血清S100β蛋白含量升高能間接反映麻醉后患兒發(fā)生不同程度的腦損傷,并可作為患兒術后早期發(fā)生POCD的檢測指標。丙泊酚及依托咪酯麻醉對患兒術后早期POCD發(fā)生率及麻醉后血清S100β蛋白含量變化無明顯差異。
[Abstract]:Objective to evaluate the lack of objective methods for the diagnosis of postoperative cognitive dysfunction (postoperative cognitive dysfunction,POCD). By comparing the effects of propofol and etomidate anesthesia on early cognitive function and serum S100 尾 protein level, the correlation between propofol and etomidate was discussed. Methods data of children with laparoscopic herniorrhaphy from July 2013 to November 1, 2014 in affiliated Hospital of Guilin Medical College were collected. Any children whose cognitive function can not be evaluated or who fail to complete the whole test are excluded from previous systemic diseases, postoperative complications and so on. 100 cases were randomly divided into propofol anesthesia group (propofol group) and etomidate anesthesia group (etomidate group). The cognitive function of children with cognitive scale 鈪，

本文編號：2331779