尼卡地平控制性降压对腹腔镜下行直肠癌根治术老年患者术后认知功能的影响

The Impact of Control Reduction of Blood Pressure with Nicardipine on their Cognitive Function after Peritoneoscopically Radical Resection of Rectal Carcinoma in Senile Patients

为探讨尼卡地平控制性降压对腹腔镜下行直肠癌根治术的老年患者术后认知功能的影响，将择期腹腔镜下行直肠癌根治术的老年患者80例，随机分为控制性降压组和对照组各40例。控制性降压组于手术开始后静脉输注尼卡地平0．5～6μg／（kg·min）行控制性降压，维持平均动脉压（MAP）较麻醉前降低30％左右（不低于60mmHg）。对照组不行控制性降压。两组于麻醉诱导前（基础状态）及术后24h、48h应用简易智能状态检查法（MMSE）评估认知功能。结果显示，控制性降压组术中MAP较对照组明显降低（P〈0．05）；与基础值比较，术后24h、48h两组MMSE评分差异无统计学意义（P〉0．05）；两组患者均未发生术后认知功能障碍。结果表明，尼卡地平0．5～6μg／（kg·min）行控制性降压，对腹腔镜下行直肠癌根治术老年患者术后认知功能无明显影响。

The objective of the study was to analyzed the impact of control reduction of blood pressure （CRBP） with nicardipine on their cognitive function after peritoneoscopically radical resection of rectal carcinoma（PRRRC） in senile patients. Eighty senile patients with rectal carcinoma were evenly randomized into two groups. The 40 cases in the study group received CRBP [nicardipine 0.5-6μg/（kg ·min）,iv] after the operation started,and the mean arterial pressure（MAP） maintained 70% of that before anesthesia （not less than 60mmHg）,while patients in the control group received no CRBP. Mini-mental state examination （MMSE） was adopted to evaluate the postoperative cognitive function which was measured before the in- duced anesthesia,postoperative 24th and 48th hours. As results, the intraoperative MAP was notably reduced in the study group than that in the control group（ P〈0.05） ;there was no statistical significance in MMSE scores（postoperative 24th ＆- 48tb scores,compared with that of basic scores） in the two groups（ P 〉0.05） ;No postoperative cognitive disturbance was noticed in the two groups. It is concluded that CRBP with nicardipine 0. 5-6μg/（kg · min） brings no notable negative effect on the cognitive function after PRRRC in senile patients.