本文關(guān)鍵詞： 右美托咪定 認(rèn)知功能 炎癥因子 神經(jīng)損傷標(biāo)志物 老年人 食管癌根治術(shù) 胸腔鏡手術(shù) 麻醉　出處：《山東醫(yī)藥》2017年23期 　論文類型：期刊論文

【摘要】：目的探討全麻氣管插管后靜脈泵入右美托咪定對胸腔鏡食管癌根治術(shù)老年患者術(shù)后認(rèn)知功能及血清炎癥因子、神經(jīng)損傷標(biāo)志物水平的影響。方法將80例接受胸腔鏡食管癌根治術(shù)治療的老年患者隨機(jī)分為右美托咪定組和對照組,各40例。兩組采用單腔氣管插管下靜脈麻醉,右美托咪定組全麻氣管插管后靜脈泵入右美托咪定,對照組組靜脈泵入等量生理鹽水。于麻醉開始前(T_1)、手術(shù)結(jié)束時(T_2)、術(shù)后1天(T_3)、術(shù)后3天(T_4)取患者靜脈血檢測血清炎癥因子腫瘤壞死因子(TNF-α)、白細(xì)胞介素1β(IL-1β)及血清神經(jīng)損傷標(biāo)志物S100β、神經(jīng)特異性烯醇化酶(NSE)水平。于T_1、T_3、T_4時間點采用簡易智力狀態(tài)檢查法(MMSE)評估患者認(rèn)知功能。結(jié)果與T_1相比,T_2、T_3兩組患者血清S100β、NSE水平上升(P均0.01),T_2、T_3、T_4兩組患者血清TNF-α、IL-1β水平上升(P均0.01)。與對照組相比,右美托咪定組患者T_2、T_3時間點血清S100β、NSE水平較低(P均0.01),T_2、T_3、T_4時間點血清TNF-α、IL-1β水平較低(P均0.01)。與T_1相比,T_3、T_4兩組患者M(jìn)MSE評分下降(P均0.01);與對照組相比,右美托咪定組患者T_3、T_4時間點MMSE評分較高(P均0.01)。結(jié)論全麻氣管插管后靜脈泵入右美托咪定可以減輕老年患者胸腔鏡人工氣胸下食管癌根治術(shù)后認(rèn)知功能下降,降低血清S100β、NSE、TNF-α、IL-1β水平。
[Abstract]:Objective to investigate the effects of intravenous infusion of dexmetomidine on postoperative cognitive function and serum inflammatory factors in elderly patients undergoing thoracoscopic radical resection of esophageal cancer after general anesthesia. Methods 80 elderly patients undergoing thoracoscopic radical resection of esophageal cancer were randomly divided into dexmetomidine group and control group, 40 patients in each group were anesthetized by single lumen endotracheal intubation, the two groups were randomly divided into two groups: dexmetomidine group (n = 40) and control group (n = 40). Dexmetomidine group received intravenous infusion of dexmetomidine after tracheal intubation under general anesthesia. The control group was injected with the same amount of normal saline. Before the anesthesia began, the patients were given T _ (1). After operation, the patients were given T2P, 1 day after operation, 3 days after operation, and 3 days after operation.) the venous blood samples of the patients were taken to detect the levels of inflammatory factor tumor necrosis factor TNF- 偽, interleukin-1 尾 and IL-1 尾) and the nerve in serum. The level of S100 尾, neuro-specific enolase (NSE). The cognitive function of patients was evaluated by MMSEE at T _ 1 / T _ 3T _ 4 at T _ 1 / T _ 3T _ 4. Results compared with T _ 1, T _ (2) T _ (2) T _ (2) T _ (3) increased the serum S100 尾 -NSE level (P = 0.01) and T _ (2) T _ (2) T _ (+) T _ 3 / T _ 4 levels increased in both groups. The serum levels of TNF- 偽 and IL-1 尾 were increased by 0.01 渭 g / L, and compared with those in the control group. The serum S100 尾 -NSE level of patients in the right metoimidine group was lower than that of the patients in the control group at the time of T _ 2C _ 2 / T _ 3 (P < 0.01). The serum levels of TNF- 偽 and IL-1 尾 were lower than those in the T _ 1 + T _ 1 + T _ 3T _ 3 group, and the MMSE scores of the patients in the two groups were lower than those in the control group (P < 0.01), and compared with those in the control group, the levels of serum TNF- 偽 and IL-1 尾 were lower than those in the control group. Conclusion intravenous infusion of dexmetomidine after tracheal intubation can alleviate the decrease of cognitive function and decrease the level of serum S100 尾 -NSENSE- 偽 and IL-1 尾 after radical resection of esophageal carcinoma under thoracoscopic pneumothorax in patients with dexmetomidine.
【作者單位】： 四川省腫瘤醫(yī)院;沈陽體育學(xué)院運動人體科學(xué)學(xué)院;
【基金】：國家自然科學(xué)基金項目(81171034)
【分類號】：R614;R735.1

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