摘要
目的探讨在高选择性癫痫病灶切除术后应用盐酸纳美芬后对术后认知功能的影响。方法选择湖南省第二人民医院癫痫手术50例,随机分为对照组(C组,n=25)和盐酸纳美芬组(N组,n=25)两组。对照组采取常规治疗,而纳美芬治疗组患者在常规治疗的基础上,从术后第1天开始静脉滴注盐酸纳美芬8μg/(kg·d),持续6 d。C组与N组患者均于术前(d0),术后第2天(d2)、第4天(d4)、第6(d6)时抽取空腹血,测定皮质醇及血糖值。选取手术前一天与手术后的第7天进行简易智力状态测试(MMSE),进行评分并计算术后认知功能障碍发生率。结果两组患者术前性别比、年龄、BMI、ASA的分级等一般情况,差异无统计学意义(P>0.05);在d2、d4、d6各时间点,N组患者的血浆皮质醇、血糖浓度均显著低于常规治疗组(P<0.05);同C组比较N组术后出现认知功能障碍的发生率较低,差异有统计学意义(P<0.05)。结论在高选择性癫痫病灶切除术后应用盐酸纳美芬可通过降低术后应激反应降低患者术后早期认知功能障碍的发生率。
【Objective】To study the effect of nalmefene on the earlier postoperative cognitive in patients undergoing Highly selective surgical resection of epileptic foci.【Methods】Fifty epilepsy patients undergoing Highly selective surgical resection of epileptic foci were randomly divided into nalmefene hydrochloride treatment group（n=25） and control group（n=25）.The patients in control group received conventional treatment,while those in nalmefene hydrochloride treatment group were administrated with nalmefene hydrochloride 8 μg/（kg·d） by intravenous infusion for 6 days in addition to the conventional treatment.Plasma cortisol and glucose concentration of patients were detected on day 0（d0）,day 2（d2）,day 4（d4）,day 6（d6）. The cognitive function of patients in both groups were tested by mini-mental state examination（MMSE）and the incidence rate of cognitive dysfunction were measured after surgery.【Results】1.There were no significant differences（p 0.05） between the both groups in age, gender, ASA degree, and BMI. 2. The cortisol and glucose concentration decreased significantly after the surgery in group N compared to group C. 3. MMSE scores were significantly higher and the incident rates of POCD were lower in group N than those in group C at 7 days after surgery（ P〈0.05）. 【Conclusion】Nalmefene used in Highly selective surgical resection of epileptic foci could reduce the incidence of postoperative cognitive dysfunction whose mechanism could be reducing stress response.
出处
《中国医学工程》
2015年第10期22-23,共2页
China Medical Engineering
