高压氧预适应联合依达拉奉对心脏瓣膜置换术后患者神经认知功能、生活质量及炎症因子水平的影响

Effects of hyperbaric oxygen preconditioning combined with Edaravone on neurocognitive function,quality of life and the levels of inflammatory factors in patients after cardiac valve replacement

目的探讨高压氧预适应联合依达拉奉对心脏瓣膜置换术后患者的神经认知功能、生活质量及炎症因子水平的影响。方法选取2013年4月~2015年8月于右江民族医学院附属医院胸心血管外科行心脏瓣膜置换术的64例患者为研究对象,依据治疗方案的不同将患者分为依达拉奉组(单独组)和高压氧预适应+依达拉奉组(联合组),每组各32例,分别比较两组患者神经认知功能、生活质量和炎症因子水平的改变。结果术后,单独组患者语言即刻记忆、注意和计算、短程记忆和言语表达均较术前明显降低(P<0.05),而联合组上述指标与术前比较差异无统计学意义(P>0.05);术后,两组患者生活质量中生理功能、生理职能、社会功能、躯体疼痛、活力、情感职能、精神健康和总体健康得分值均明显升高,而且联合组的升高幅度显著优于单独组(P<0.05);联合组患者的炎性反应因子白细胞介素-6、8、12、16和肿瘤坏死因子-α水平的改善程度均明显优于单独组(P<0.05)。结论高压氧预适应联合依达拉奉可显著改善心脏瓣膜置换术后患者的神经认知功能,降低炎症因子水平,提高生活质量。

Objective To investigate the clinical effects of hyperbaric oxygen preconditioning combined with Edaravone on neurocognitive function, quality of life and the levels of inflammatory factors in patients after cardiac valve replace- ment. Methods Sixty four cases of patients taken cardiac valve replacement in Department of Thoracic and Cardiovas- cular Surgery, Affiliated Hospital of Youjiang Medical University for Nationalities from April 2013 to August 2015 were selected as research objects, and they were divided into Edaravone group （single group） and hy^perbaric oxygen precon- ditioning plus Edaravone group （combined group） according to different treating regimens, each group had 32 cases. The pression were significantly reduced in single group （P 〈 0.05）, while there were no significant differences in the combined group before and after surgery （P 〉 0.05）; after surgery, the scores of life quality on physiological functioning, role physical, social functioning, bodily pain, vitality, role emotion, mental health, generai health of the two groups Were sig- nificantly increased, and the improvements of combined group were significantly better than those of single group （P 〈 0.05）; moreover, improvements of the levels of inflammatory reaction factor interleukin-6, 8, 12, 16 and tumor necrosis fac- tor-α in the combined group were also better than those of the single group （P 〈 0.05）. Conclusion Hyperbaric oxygen preconditioning combined with Edaravone can significantly improve the neurocognitive function of patients treated with cardiac valve replacement, decrease the levels of inflammatory factors, and enhancethe quality of life.