【摘要】：目的觀察右美托咪定(DEX)對全麻下老年患者甲狀腺癌根治術(shù)后早期認知功能障礙(POCD)的影響。方法選擇2014年2~5月在該院擇期行甲狀腺癌根治術(shù)患者60例。隨機分為DEX組和生理鹽水對照組,每組30例。兩組患者均采用全憑靜脈麻醉,DEX組患者誘導前經(jīng)靜脈輸注DEX 0.5μg/kg持續(xù)輸注10 min,隨后0.3μg·kg-1·h-1的速度輸注至淋巴結(jié)清除結(jié)束;對照組以相同方式輸注生理鹽水。記錄兩組患者年齡、性別、體重及手術(shù)時間;術(shù)中輸注全麻藥總量;分別于術(shù)前1 d及術(shù)后第1、7天使用簡易智能精神狀態(tài)檢查量表(MMSE)進行評分,記錄POCD發(fā)病率;并分別于麻醉前(T0)、手術(shù)結(jié)束時(T1)、術(shù)后24 h(T2)抽取靜脈血,檢測血清腫瘤壞死因子(TNF)-α、白細胞介素(IL)-6、IL-10水平。結(jié)果與對照組相比,DEX組術(shù)中應用丙泊酚及瑞芬太尼的用藥量明顯減少(P0.05),術(shù)后1、7 d的MMSE評分顯著提高(P0.05)�；颊咝g(shù)后1、7 d兩組POCD發(fā)病率比較差異均無統(tǒng)計學意義(P0.05)。DEX組患者在手術(shù)結(jié)束時和術(shù)后24 h血清TNF-α、IL-6濃度較對照組明顯降低,IL-10明顯增高(P0.05)。結(jié)論 DEX夠有效減少患者術(shù)中麻醉藥用量,改善甲狀腺癌老年患者術(shù)后早期認知功能,但不能降低POCD的發(fā)生率,其機制可能與DEX能降低炎癥因子分泌和增加抗炎因子的釋放有關。
[Abstract]:Objective to observe the effect of right metomipramine (DEX) on early cognitive impairment (POCD) in elderly patients under general anesthesia after radical resection of thyroid carcinoma. Methods from February to May 2014, 60 patients with thyroid carcinoma underwent radical thyroidectomy. They were randomly divided into DEX group (n = 30) and saline control group (n = 30). All the patients in the DEX group were anesthetized by intravenous anesthesia. DEX 0.5 渭 g / kg was infused intravenously for 10 min, and then 0.3 渭 g kg- 1 路h-1 until the end of lymph node clearance, while the control group was infused with normal saline in the same way. The age, sex, body weight and operation time of the two groups were recorded, the total amount of general anesthetics was infused during operation, and the incidence of POCD was recorded by (MMSE) on the 1st day before operation and on the 1st and 7th day after operation. Venous blood samples were taken before anesthesia (T0), at the end of operation (T1) and 24 hours after operation (T2) to detect serum tumor necrosis factor (TNF)-偽, IL (IL)-6 and IL 10 levels. Results compared with the control group, the dosage of propofol and remifentanil in DEX group was significantly lower than that in control group (P 0.05), and the MMSE score at 7 d after operation was significantly increased (P 0.05). There was no significant difference in the incidence of POCD between the two groups on the 1st and 7th day after operation (P 0.05). The concentrations of serum TNF- 偽 and IL-6 in the). DEX group were significantly lower than those in the control group at the end of operation and 24 hours after operation, and the IL-10 was significantly higher than that in the control group (P 0.05). Conclusion DEX can effectively reduce the dosage of anesthetics during operation and improve the early cognitive function of elderly patients with thyroid cancer, but it can not reduce the incidence of POCD. The mechanism may be related to DEX can reduce the secretion of inflammatory factors and increase the release of anti-inflammatory factors.
【作者單位】： 吉林大學白求恩第一醫(yī)院;赤峰市醫(yī)院麻醉科;
【分類號】：R614

【共引文獻】

相關期刊論文 前10條

1 王立功;楊曉凌;;地佐辛對瑞芬太尼麻醉后痛覺敏化的干預效應[J];甘肅醫(yī)藥;2013年11期

2 韓慶峰;萬文錦;;右美托咪啶復合異丙酚—芬太尼麻醉用于人工流產(chǎn)術(shù)中的麻醉效果[J];臨床醫(yī)學;2013年12期

3 張耀賢;張中軍;;右美托咪定抑制瑞芬太尼誘發(fā)痛覺過敏的研究進展[J];廣州醫(yī)藥;2014年01期

4 江燕;黃瑞鑫;王銀珊;洪彌瓊;張燕;;麻醉舒適醫(yī)療在甲狀腺手術(shù)中的臨床研究[J];重慶醫(yī)學;2014年09期

5 鄧薇菲;王穎;王壽勇;;右美托咪定藥理作用的研究進展[J];兒科藥學雜志;2014年09期

6 劉樺;黃金平;李麗妍;;右美托咪定對全麻下髖關節(jié)置換術(shù)術(shù)后認知功能的影響[J];中國醫(yī)藥科學;2014年15期

7 趙建;丁日高;;膽堿能抗炎通路的研究進展[J];國際藥學研究雜志;2014年06期

8 李以茂;熊p蕓，

本文編號：2522098