乌司他丁对老年胃癌患者术后认知功能障碍的影响

Effect of ulinastatin on postoperative cognitive function in elderly gastric cancer surgery

目的探讨乌司他丁对老年胃癌患者术后认知功能障碍的影响。方法将符合标准的200例老年胃癌手术患者分成观察组(100例)和对照组(100例),观察组患者在术前与术后均给予乌司他丁,对照组仅给予生理盐水。结果在术中,观察组的尿量为(441.7±78.5)mL,显著性低于对照组的(613.2±81.2)mL(P<0.05)。在治疗后,观察组的联想学习及对照组的简易精神状态检查(MMSE)、视觉再生、联想学习评分均低于治疗前(P<0.05);治疗后观察组的MMSE、视觉再生、联想记忆的评分分别为24.4±1.5、9.7±1.7、12.4±1.8,均显著高于对照组的21.1±1.0、8.7±1.5、11.3±1.7,差异有统计学意义(P<0.05)。在术毕、术后1d、术后3d,观察组患者的血清S100β蛋白水平分别为(0.099±0.024)、(0.074±0.026)、(0.061±0.022)μg/L,均显著低于对照组的(0.138±0.042)、(0.110±0.034)、(0.075±0.031)μg/L(P<0.05)。结论乌司他丁不仅能够改善老年患者术后认知功能障碍,同时也能够降低术后血清S100β蛋白的水平,对患者的脑组织起到保护作用。

Objective To integrative the effect of ulinastatin on postoperative cognitive function in elderly gastric cancer surgery.Methods Two hundred elderly patients with gastric cancer surgery were randomly divided into observed group（100cases）and control group（100cases）.Patients in observed group received the intravenous drip of ulinastatin before and after the surgery,while others only received the intravenous drip of physiological saline before and after the surgery.Results The urine output of observed group was（441.7±78.5）mL,which was significantly lower than that in control group as the result was（613.2±81.2）mL（P〈0.05）.After the treatment,the score of MMSE,visual regeneration and association learning in both observed group and control group were significantly lower than that before the treatment（P〈0.05）.The scores of MMSE,visual regeneration and association learning in observed group were 24.4±1.5,9.7±1.7and 12.4±1.8,which were significantly higher than that in control group as the scores were 21.1±1.0,8.7±1.5and 11.3±1.7（P〈0.05）.The level of S100βin serum of observed group at the end of surgery,1day and 3day after the surgery were（0.099±0.024）μg/L,（0.074±0.026）μg/L and（0.061±0.022）μg/L,which were significantly lower than that in control group as the results were（0.138±0.042）μg/L,（0.110±0.034）μg/L and（0.075±0.031）μg/L（P〈0.05）.Conclusion Ulinastatin can not only improve the postoperative cognitive dysfunction in elderly patients with postoperative,but can also reduce the level of S100βin serum.It provides brain protection for patients.