右美托咪定对老年结肠癌手术后认知功能障碍的影响

Effect of dexmedetomidine on postoperative cognitive dysfunction in elderly patients with colorectal cancer

目的探讨右美托咪定对老年结肠癌手术后认知功能障碍(POCD)的影响。方法选取2016年1月至2019年10月市就诊大连市中心医院的行全麻腹腔镜结直肠癌根治术的老年患者160例,根据麻醉方式不同分为对照组和DEX组,每组80例。对照组患者使用生理盐水,DEX组患者使用右美托咪定麻醉镇静,记录手术情况,比较两组POCD发生率和认知功能评分(MMSE评分)。ELISA检测血清中S100-β和IL-6的表达水平并进行比较。结果DEX组与对照组相比,麻醉时间和术中失血明显降低(P<0.05)。术后1天和术后3天,DEX组患者的MMSE评分均高于对照组(P<0.05)。DEX组POCD发生率明显低于对照组(P<0.05)。与术前相比,术后1天和3天患者的S100-β和IL-6表达增加;与对照组相比,DEX组患者的术后1天和3天患者的S100-β和IL-6表达降低,差异均有统计学意义(P<0.05)。结论右美托咪定可明显减轻老年结直肠癌患者术后认知障碍。

Objective To investigate the effect of dexmedetomidine-assisted general anesthesia on early postoperative cognitive dysfunctions in elderly patients with colorectal cancer.Methods In total,160 patients with colorectal cancer,who underwent general anesthesia from January 2016 to October 2019 in Dalian Central Hospital Affiliated to Dalian Medical University,were enrolled.They were divided into two groups,including 80 patients in the dexmedetomidine group(DEX group)and 80 patients in the saline group(control group).Surgery conditions were observed,and the incidence of postoperative cognitive dysfunction(POCD)and cognitive function score(MMSE score)were compared between the two groups.Serum levels of S100-βprotein and interleukin-6(IL-6)were measured by enzyme-linked immunosorbent assay.Results The anesthesia time and intraoperative blood loss in DEX group were significantly lower than those in control group(P<0.05).The MMSE scores in DEX group on the 1 st and 3 rd day after surgery were higher than those in control group(P<0.05).The incidence of POCD in DXE group was significantly lower than that in control group(P<0.05).Serum levels of IL-6 and S100-βincreased on the 1 st and 3 rd day after surgery compared with those before surgery(P<0.05).The serum levels of IL-6 and S100-βin control group were significantly higher than those in DEX group on the 1 st and 3 rd day after surgery(P<0.05).Conclusions Dexmedetomidine can significantly improve postoperative cognitive dysfunction in elderly patients with colorectal cancer.