二氧化碳气腹压力对宫颈癌微创手术妇女认知功能水平影响的研究

Study on effect of carbon dioxide pneumoperitoneum pressure on cognitive function of women undergoing minimally invasive cervical cancer surgery

目的探讨宫颈癌微创手术后二氧化碳气腹压力对患者认知功能的影响。方法以2017年7月—2019年10月濮阳市油田总医院收治的152例宫颈癌手术患者为研究的对象,根据随机数字表法分为微创组与外科组,每组76例。比较两组研究对象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)水平,采用简易智力量表(MMSE)综合评估术后早期认知功能变化。将微创组根据病程及分期,采用随机区分法分为A、B两组,予以不同气腹压力,比较不同气腹压对患者的认知功能的影响。结果①术后微创组与外科组的NSE、S100β较术前显著升高,MMSE评分显著下降(P<0.05);术后12 h,微创组的NSE、S100β显著高于外科组,其MMSE评分显著低于外科组(P<0.05);术后24 h,微创组的NSE、S100β显著高于外科组(P<0.05),但MMSE评分比较差异无统计学意义(P>0.05)。②术后A、B两组的NSE、S100β较术前显著升高,MMSE评分仍显著下降(P<0.05);术后12 h,A组的NSE、S100β较术前显著低于B组(P<0.05),两组的MMSE评分比较,差异均无统计学意义(P>0.05);术后24 h,两组的各项评分比较,差异均无统计学意义(P>0.05)。③B组并发症总发生率(13.16%)与A组(5.26%)比较,差异均无统计学意义(P>0.05)。结论宫颈癌患者可采取腔镜手术治疗,且术中采用较低的二氧化碳气腹压力对患者认知功能的影响更小。

Objective To investigate the effect of carbon dioxide pneumoperitoneum pressure on patients'cognitive function after minimally invasive surgery for cervical cancer patients in our hospital.The levels of neuron-specific enolase(NSE)protein and central neuro-specific protein(S100)in the venous blood of subjects in the two groups were compared,and the comprehensive assessment of early postoperative cognitive function was performed using the simple intelligence scale(MMSE).The minimally invasive group was randomly divided into two groups,A and B,according to the disease course and stage.Different pneumoperitoneum pressures were applied to compare the effects of different pneumoperitoneum pressures on patients'cognitive function.Results①NSE and S100 of postoperative minimally invasive group and surgical group increased significantly compared with that before surgery,and MMSE score decreased significantly(P<0.05).At 12 h after surgery,the NSE and S100 of minimally invasive group were significantly higher than that of surgery group,and the MMSE score was significantly lower than that of surgery group(P<0.05).24 h after surgery,NSE and S100 of minimally invasive group were significantly higher than that of surgical group(P<0.05),but MMSE score was compared(P>0.05).②postoperative NSE and S100 of group A and group B were significantly increased compared with that before surgery,and the MMSE score was still significantly decreased(P<0.05).At 12 h after surgery,NSE and S100 of group A were significantly lower than that of group B before surgery(P<0.05),and there was no statistically significant difference in MMSE scores between the two groups(P>0.05).At 24 h after surgery,there was no statistically significant difference in scores between the two groups(P>0.05).③the total incidence of complications in group B was 13.16%,which was not statistically significant compared with 5.26%in group A(P>0.05).Conclusion Patients with cervical cancer can be treated by endoscopic surgery,and the lower CO2 pneumoperitoneum pressure during the operation has less effect on patients'cognitive function.