天麻素联合瑞芬太尼对宫颈癌根治术后脑代谢及认知功能的影响

Effect of Gastrodin Combined with Remifentanil on Brain Metabolism and Cognitive Function After Radical Hysterectomy of Cervical Cancer

目的探讨天麻素注射液联合瑞芬太尼对宫颈癌根治术后脑代谢及认知功能的影响。方法选择医院2016年3月至2017年5月收治的行腹腔镜下宫颈癌根治术患者87例,随机分为对照组(43例)和观察组(44例)。两组患者均行常规监测及治疗,对照组患者用瑞芬太尼进行麻醉诱导,观察组患者在此基础上加用天麻素注射液。结果观察组患者睁眼、拔管及苏醒的时间均明显短于对照组(P <0.05);与术前(T_0)比较,两组患者术后6 h (T_1)、术后24 h (T_2)和术后72 h (T_3)时简易智力状态检查量表(MMSE)评分,颈静脉球部氧饱和度(SjvO_2),颈静脉球部氧分压(PjvO_2),脑氧饱和度(rSO_2)水平均明显降低,而脑氧摄取率(CEO_2)和动-颈静脉血氧含量差值(AVDO_2)水平均明显升高(P <0.05),观察组患者T_2和T_3时的MMSE评分和T_1,T_2,T_3时上述其他指标改善情况均明显优于对照组(P <0.05);两组不良反应发生率相当(6.98%比4.55%,P> 0.05)。结论天麻素注射液联合瑞芬太尼,可有效改善宫颈癌根治术后脑代谢和认知功能,改善预后,且不增加不良反应。

Objective To investigate the effect of Gastrodin Injection combined with remifentanil on brain metabolism and cognitive function after radical hysterectomy of cervical cancer.Methods Totally 87 patients undergoing laparoscopic radical hysterectomy of cervical cancer admitted to our hospital from March 2016 to May 2017 were selected and randomly divided into the control group(43 cases)and the observation group(44 cases).The patients in the two groups were given routine monitoring and treatment,the patients in the control group were anesthetized with remifentanil,on this basis,the patients in the observation group were given Gastrodin Injection.Results The time of opening eyes,extubation and awakening in the observation group was significantly shorter than that in the control group(P<0.05).Compared with preoperative(T0),the Mini-Mental State Examination(MMSE)score,the levels of jugular bulb venous oxygen saturation(SjvO2),jugular bulb venous oxygen partial pressure(PjvO2)and cerebral oxygen saturation(rSO2)were significantly decreased at 6 h(T1),24 h(T2)and 72 h(T3)postoperatively in the two groups,while the cerebral extraction of oxygen(CEO2)and arteriovenous oxygen difference(AVDO2)level were significantly increased in the two groups(P<0.05).The improvement of MMSE score at T2 and T3 and other indexes at T1,T2 and T3 in the observation group was significantly better than that in the control group(P<0.05).The incidence rate of adverse reactions was similar between the two groups(6.98%vs.4.55%,P >0.05).Conclusion Gastrodin Injection combined with remifentanil can effectively improve brain metabolism and cognitive function after radical hysterectomy of cervical cancer,improve prognosis without increasing adverse reactions.