宫颈癌腹腔镜手术中不同二氧化碳气腹压力对患者认知功能的影响

Effects of different carbon dioxide pneumoperitoneum pressures on women’s cognitive function in laparoscopic cervical cancer surgery

目的:探讨不同二氧化碳气腹压力对宫颈癌腹腔镜手术患者认知功能水平的影响。方法:选择宫颈癌并行腹腔镜手术患者90例,按照随机数字表法分为A、B、C三组,三组患者在手术过程中给予不同的二氧化碳气腹压力,然后比较术前及术后三组患者的静脉血中神经元特异性烯醇化酶(NSE)蛋白和中枢神经特异性蛋白(S100β)含量及患者认知功能水平。结果:术毕A组和B组患者NSE及S100β的含量均明显低于C组。三组患者的简易精神状态量表(MMSE)评分术后1 d均比术前有所降低,但都没有达到认知功能受影响的标准,且C组明显低于A组,三组患者的MMSE评分术后3 d均有所回升,且组间比较差异均无统计学意义。结论:低二氧化碳气腹压能减少术后宫颈癌微创手术患者血液中二氧化碳分压(PaCO 2)值及NSE和S100β的蛋白含量,二氧化碳气腹压力对宫颈癌微创手术患者的认知功能水平的影响不大。

Objective:To investigate the effects of different carbon dioxide pneumoperitoneum pressures on the cognitive function of women undergoing laparoscopic surgery for cervical cancer.Methods:A total of 90 cases of cervical cancer undergoing laparoscopic surgery were collected.The selected patients were divided into 3 groups,3 groups of patients were given different carbon dioxide pneumoperitoneum pressure during the operation,and then the contents of neuron-specific enolase(NSE)protein and central nervous system specific protein(S100β)protein in venous blood of the 3 groups of patients before and after the operation were compared,as well as the cognitive function levels of the 3 groups of patients before and after the operation.Results:The contents of NSE and S100βin group A and group B were significantly lower than those in group C.The MMSE score of the patients in the three groups was decreased 1 d after surgery compared with that before surgery,but all of them did not reach the standard of affected cognitive function,and the MMSE score of the patients in the C group was significantly lower than that in the A group.The MMSE score of the patients in the three groups was increased 3 days after surgery,and the differences between the groups were not statistically significant.Conclusion:Low carbon dioxide pneumoperitoneum pressure can reduce the blood PaCO 2 value and the content of NSE and S100βprotein in patients with minimally invasive cervical cancer surgery after surgery,and the effect of carbon dioxide pneumoperitoneum pressure on the cognitive function level of women with minimally invasive cervical cancer surgery is not significant.