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不同剂量右美托咪定麻醉对老年食管癌根治术患者血清因子及简易智能状态量表评分的影响

Effect of anesthesia with different doses of dexmedetomidine on serum factors and score of Mini-Mental State Examination in elderly patients with radical resection of esophageal cancer

    摘要
  • 摘要:
      目的  探讨不同剂量右美托咪定麻醉对老年食管癌根治术患者血清因子及简易智能状态量表(MMSE)评分的影响。
      方法  选取行食管癌根治术的老年患者60例，按右美托咪定使用剂量分为低剂量组(0.50 μg/kg)与高剂量组(1.00 μg/kg)各30例，另选取30例使用生理盐水患者为对照组。比较3组患者麻醉诱导即刻(T1)、术毕(T2)及术后第1天(T3)、术后第7天(T4)血清相关因子，以及术前24 h及术后第1、3、7天认知功能变化情况。
      结果  3组患者T1时超氧化物歧化酶(SOD)活性、丙二醛(MDA)含量对比，差异均无统计学意义(P>0.05)。3组T2、T3的SOD活性均显著低于T1(P < 0.05)。高剂量组SOD活性、MDA含量显著优于其他2组(P < 0.05)。3组患者T2、T3、T4时白介素-6(IL-6)、神经元特异性烯醇化酶(NSE)水平均显著高于T1时(P < 0.05); T2、T3时，高剂量组IL-6、NSE水平均显著低于其他2组(P < 0.05)。术后第1天, 3组MMSE评分均显著低于术前24 h, 且高剂量组MMSE评分显著高于其他2组(P < 0.05)。术后第3天，高剂量组MMSE评分显著高于低剂量组、对照组(P < 0.05)。
      结论  老年食管癌根治术患者治疗期间选用1.00 μg/kg高剂量右美托咪定，能够有效提高患者血清SOD活性及MDA含量，降低炎症因子水平，促进患者术后认知功能的改善。

     

    Abstract:
      Objective  To investigate the effect of anesthesia with different doses of dexmedetomidine on serum factors and score of Mini-Mental State Examination (MMSE) in elderly patients with radical resection of esophageal cancer.
      Methods  Totally 60 elderly patients with radical resection of esophageal cancer were divided into low-dose group (0.50 μg/kg dexmedetomidine) and high-dose group (1.00 μg/kg dexmedetomidine), with cases in each group. Another 30 patients with normal saline were selected as control group. The levels of serum related factors at the time points of anesthesia induction (T1), the end of operation (T2), the first day after operation (T3) and the seventh day after operation (T4) as well as the changes of cognitive function at 24 hours before operation and 1, 3 and 7 days after operation were compared among the three groups.
      Results  There were no significant differences in superoxide dismutase (SOD) activity and malondialdehyde (MDA) content at T1 among the three groups (P>0.05). The SOD activity at T2 and T3 in three groups was significantly lower than that at T1 in three groups (P < 0.05). SOD activity and MDA content in high-dose group were significantly better than those in other two groups (P < 0.05). The levels of interleukin-6 (IL-6) and neuron specific enolase (NSE) at T2, T3 and T4 were significantly higher than those at T1 n three groups (P < 0.05). The levels of IL-6 and NSE at T2 and T3 in high-dose group were significantly lower than those in other two groups (P < 0.05). On the first day after operation, the MMSE scores of the three groups were significantly lower than those before operation, and score of high-dose group was significantly higher than that in the other two groups (P < 0.05). On the third day after operation, MMSE score of high-dose group was significantly higher than that of low-dose group and control group (P < 0.05).
      Conclusion  For elderly patients with radical resection of esophageal cancer, 1.00 μg/kg dexmedetomidine can effectively increase the SOD activity and MDA content, reduce the level of inflammatory factors, and improve the cognitive function.

     

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