不同剂量右美托咪定对老年非小细胞肺癌患者术后认知功能及E-selectin、β-EP的影响

The influence of dexmedetomidine at different doses on postoperative cognitive function and levels of E-selectin andβ-EP in elderly patients with non-small cell lung cancer

目的探讨不同剂量右美托咪定对老年非小细胞肺癌患者术后认知功能及E-选择素(E-selectin)、β-内啡肽(β-EP)水平的影响。方法选择2017年12月—2019年3月本院收治的106例老年NSCLC患者作为研究对象,按照随机数表法分为实验组和对照组两组,每组各53例。对照组使用0.5μg/kg右美托咪定,实验组使用1μg/kg右美托咪定。统计比较两组患者心率(HR)、平均动脉压(MAP)、血清E-selectin及β-EP水平、疼痛程度(VAS)、认知功能(MMSE)、不良反应。结果T0、T1、T2、T3时,两组患者HR、MAP水平比较,差异无统计学意义(P>0.05);T0、T1、T2、T3时,两组患者血清E-selectin、β-EP水平比较,差异无统计学意义(P>0.05);术前、术后6 h、12 h、24 h、48 h,两组患者VAS评分比较,差异无统计学意义(P>0.05);术后第1天、第3天、第7天,试验组患者的MMSE评分高于对照组,差异有统计学意义(P<0.05);实验组患者不良反应发生率(7.55%)低于对照组(22.64%),差异有统计学意义(P<0.05)。结论1μg/kg右美托咪定应用于老年NSCLC患者,对术后认知功能具有保护作用,且不良反应发生少。

Objective To investigate the effects of dexmedetomidine at different doses on postoperative cognitive function,E-selectin and β-endorphin(β-EP)levels in elderly patients with non-small cell lung cancer(NSCLC).Methods From December 2017 to March 2019,106 elderly patients with NSCLC those admitted to our hospital were selected as study subjects and they were divided into experimental group and control groupaccording to random number table method,53 cases in each group.Patients in control group received 0.5μg/kg dexmedetomidine and patients in the experimental group received 1μg/kg dexmedetomidine.Heart rate(HR),mean arterial pressure(MAP),serum E-selectin and β-EP levels,pain degree(VAS),cognitive function(MMSE)and adverse reactions were compared between the two groups.Results There were no significant differences in HR and MAP levels between the two groups at T0,T1,T2 and T3(P>0.05).There were no significant differences in serum E-selectin andβ-EP levels between the two groups at T0,T1,T2 and T3(P>0.05).There were no significant differences in VAS scores between control group and experimental group at time points before surgery,and at 6 thh,12 thh,24 thh and 48 thh after surgery(P>0.05).MMSE score in experimental group was higher than that in control group on the 1 st,3 rd and 7 th day after surgery(P<0.05).The incidence of adverse reactions in experimental group(7.55%)was lower than that in control group(22.64%),the difference was statistically significant(P<0.05).Conclusions Dexmedetomidine at the dose of 1μg/kg could protect postoperative cognitive function in elderly patients with NSCLC,with less adverse reactions.