急性高容量血液稀释结合控制性降压对老年直肠癌根治术患者术后认知功能的影响

Effects of acute hypervolemic hemodilution combined with controlled hypotension on postoperative cognitive dysfunction in the elderly undergoing radical resection of rectal carcinoma

目的观察急性高容量血液稀释结合控制性降压在老年直肠癌根治术中应用对术后认知功能的影响。方法选择168例行直肠癌根治术的患者,随机分成4组:对照组(常规处理组)、急性血液稀释(AHH)组、控制性降压(CH)组、AHH+CH组,监测分析与术后认知功能障碍的相关因素。结果 CH组及AHH+CH组术后认知功能障碍的发生率分别为38.10%、33.33%,均高于对照组(28.57%)及AHH组(26.19%),差异有统计学意义(P<0.05)。结论 AHH结合CH在老年直肠癌根治术中应用时术后认知功能障碍的发生率较高,降压和所用药物硝酸甘油为其主要影响因素。

Objective To observe the effect of acute hypervolemic hemodilution combined with controlled hypotension on postoperative cognitive dysfunction in the elderly receiving radical resection of rectal carcinoma. Methods 168 cases receiving radical resection of rectal cancer were randomly divided into 4 groups, control group (routine treatment group), acute hemodilution(AHH) group, controlled hypotension(CH) group and acute hypervolemic hemodilution combined with controlled hypotension(AHH+CH) group. The related factors of postoperative cognitive dysfunction were monitored and analyzed. Results The incidences of postoperative cognitive dysfunction in CH group (38.10%) and AHH+CH group(33.33%) were significantly higher than those in the other groups(P<0.05). Conclusions The incidence of postoperative cognitive dysfunction is high in the elderly patients with rectal cancer undergoing radical resection receiving acute hypervolemic hemodilution combined with controlled hypotension. Anti-hypertension treatment and the use of nitroglycerin may be the main influencing factors.