硬膜外麻醉和全身麻醉对高龄患者腹部术后谵妄及GFAP、MT、NGAL、相关细胞因子的影响

Impact of Epidural Anesthesia and General Anesthesia on the Occurrences of Delirium and GFAP,MT and NGAL and Cell Factors after Abdominal Surgery

目的:分析高龄病患在实施腹部手术时采用全身麻醉与硬膜外麻醉效果差异。方法:选择在本院进行腹部手术治疗的86例高龄病患为研究样本,其研究时间均在2018年1月-2020年1月。采取随机数字排列表法将其分成观察组(43例)以及对照组(43例),予以观察组病患硬膜外麻醉,予以对照组病患全身麻醉,对比2组病患手术后第1天以及第5天谵妄出现率;手术前以及手术后第5天GFAP、MT、NGAL、白细胞介素-1β、白细胞介素-6以及白细胞介素-8水平。结果:观察组病患手术后第1天以及第5天谵妄出现率均低于对照组(P<0.05)。手术后第5天观察组病患GFAP、NGAL.白细胞介素-1β、白细胞介素-6以及白细胞介素-8水平均低于对照组,MT水平高于对照组(P<0.05)。结论:高龄病患在实施腹部手术治疗时采用硬膜外麻醉,相较于全身麻醉而言可降低手术后谵妄出现率,同时对GFAP MT、NGAL、白细胞介素-1β、白细胞介素-6以及白细胞介素-8水平影响较小,可在临床高龄病患腹部手术过程中使用。

Objective:To compare the effects of general anesthesia and epidural anesthesia during abdominal surgery.Methods:86 elderly patients of undergoing abdominal surgery from January 2018 to January 2020 in our hospital were selected as research samples.According to random tabulation method,patients were divided into group A(43 cases)and group B(43 cases).Group A received epidural anesthesia;group B received general anesthesia.After Id and 5d of surgery,the occurrences of delirium were recorded;before surgery and after 5d of surgery,GFAP(glial fibrillary acidic protein),MT(melatonin),NGAL(neutrophil gelatinase-associated lipocalin),interleukin-1β,interleukin-6 and interleukin-8 levels were compared.Results:After Id and 5d of surgery,the occurrences of delirium in group A were lower than group B(P<0.05);after 5 d of surgery,GFAP,NGAL,interleukin-1β,interleukin-6 and interleukin-8 levels in group B were lower than group A;MT levels were higher than group A(P<0.05).Conclusion:During abdominal surgery,epidural anesthesia can reduce the occurrences of delirium,and produce less impact on GFAP,MT,NGAL,interleukin-1β,interleukin-6 and interleukin-8 levels.It shall be recommended in clinical use.