头部亚低温干预对腹腔镜下结直肠癌根治术患者术后认知功能的影响

Effect of head mild hypothermia intervention on postoperative cognitive function in patients undergoing laparoscopic radical resection of colorectal cancer

目的 探讨围术期头部亚低温干预对腹腔镜下结直肠癌根治术患者术后认知功能的影响。方法 100例结直肠癌患者随机均分为亚低温组(32~35℃)和对照组(常温)。分别于术前和术后第1、3及7天对两组患者行认知功能评分,并检测血清IL-6及TNF-α水平。结果 亚低温组术后的术后认知功能障碍(POCD)发生率低于对照组(14.0%vs.34.0%)(P<0.05)。两组POCD患者血清IL-6和TNF-α水平均高于非POCD患者(P<0.05)。亚低温组观察不同时间点出现POCD例数与IL-6和TNF-α水平呈正相关(r=0.998和0.952,P<0.05)。结论 胃肠手术患者围术期应用头部亚低温干预可能通过下调血液中炎症因子IL-6及TNF-α水平改善术后认知功能。

Objective To investigate the effect of perioperative head mild hypothermia intervention on the postoperative cognitive function in the patients undergoing laparoscopic radical resection of colorectal cancer.Methods One hundred patients undergoing colorectal cancer were randomly divided into two groups of A(treated with head mild hypothermia, 32-35℃) and B(treated with head normal temperature).The cognitive function scores were evaluated and serum levels of IL-6 and TNF-α were detected before operation and on the 1;,3;and 7;day after operation.Results The incidence of postoperative cognitive dysfunction(POCD) in group A was lower than that in group B(14.0% vs.34.0%)(P<0.05).Serum levels of IL-6 and TNF-α in group A were lower than those in group B on the 1;,3;and 7;day after operation(P<0.05).Serum levels of IL-6 and TNF-α of POCD patients in two groups were higher than those of non-POCD patients(P<0.05).The numbers of POCD cases at different time points were positively correlated with the levels of IL-6 and TNF-α in group A(r=0.998 and 0.952,P<0.05).Conclusion Perioperative head mild hypothermia intervention strategy in the patients undergoing gastrointestinal surgery may improve the postoperative cognitive function by down-regulating serum levels of inflammatory factors IL-6 and TNF-α.