【摘要】：目的本研究旨在觀察術(shù)前應(yīng)用地塞米松(10mg)對老年胃腸手術(shù)患者術(shù)后早期認(rèn)知功能及相關(guān)生物標(biāo)志物的影響。方法本研究為隨機(jī)對照雙盲臨床研究,通過解放軍總醫(yī)院倫理委員會(huì)審查。選擇在我院擇期行胃腸手術(shù)的患者92例,年齡≥65歲,ASA評級為Ⅱ-Ⅲ級。所有入選患者由其家屬簽署知情同意書。隨機(jī)分為對照組(C組)及地基米松組(D組),每組46例。切皮前1-2h,C組靜脈注射0.9%氯化鈉注射液2m1,D組靜脈注射地塞米松10mg(5mg/ml).術(shù)前、術(shù)后第1天及第7天上午8：00檢測血清IL(interleukin,白介素)6、CRP (C-reactive protein, C反應(yīng)蛋白)及皮質(zhì)醇濃度。術(shù)前、術(shù)后第7天應(yīng)用神經(jīng)心理學(xué)測試評估認(rèn)知功能,測試包括詞語記憶、數(shù)字連線、數(shù)字重復(fù)及數(shù)字編碼。這四項(xiàng)測試中有兩項(xiàng)或以上術(shù)后評分較術(shù)前下降20%或更多,則評定為術(shù)后認(rèn)知功能障礙(POCD)。結(jié)果C組POCD發(fā)病率為34.8%,D組為15.2%,D組較C組低19.6%(P0.05)。術(shù)后第1天,D組血清IL-6、CRP、皮質(zhì)醇濃度分別較C組低(P0.05)。術(shù)前、術(shù)后第7天兩組血清IL-6、CRP、皮質(zhì)醇濃度比較差異均無統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論術(shù)前單次應(yīng)用地塞米松10mg降低老年胃腸手術(shù)患者早期POCD發(fā)病率,同時(shí)降低術(shù)后早期血清IL-6、CRP及皮質(zhì)醇濃度。
[Abstract]:Objective to observe the effect of preoperation administration of dexamethasone (10mg) on early cognitive function and related biomarkers in elderly patients undergoing gastrointestinal surgery. Methods A randomized controlled double blind clinical study was conducted by the Ethics Committee of the General Hospital of the Chinese people's Liberation Army (PLA General Hospital). 92 patients (鈮，

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