七氟醚对老年结直肠癌手术患者氧代谢动力学及认知功能状态的影响

Influence of Sevoflurane on Oxygen Metabolism Dynamics and Cognitive Function State in Elderly Patients with Colorectal Cancer Surgery

目的:探究七氟醚对老年结直肠癌手术患者氧代谢动力学及认知功能状态的影响。方法:将2020年10月—2022年12月福建省立医院收治的80例老年结直肠癌手术患者根据随机数表法分为对照组40例和观察组40例。对照组采用丙泊酚联合瑞芬太尼干预,观察组采用七氟醚联合瑞芬太尼干预。比较两组血流动力学指标[平均动脉压(MAP)及心率(HR)]、氧代谢动力学指标[氧代谢指标:颈静脉球血氧饱和度(SjvO_(2))及颈内静脉血氧分压(PjvO_(2));乳酸指标:静脉血乳酸(LacV)及动脉血乳酸(LacA)]、认知功能状态[蒙特利尔认知评估量表(MoCA评分);认知功能血液指标:S100B蛋白(S100B)、神经元特异性烯醇化酶(NSE)及谷氨酸(Glu)]。结果:两组麻醉前血流动力学指标和氧代谢动力学指标及术前认知功能状态比较,差异无统计学意义(P>0.05);观察组手术开始、手术结束血流动力学指标及氧代谢动力学指标低于对照组,观察组术后1 d、3 d的MoCA评分高于对照组,认知功能血液指标低于对照组,差异有统计学意义(P<0.05)。结论:七氟醚可更为有效地平稳老年结直肠癌手术患者的血流动力学状态及氧代谢动力学,且对认知功能状态的不良影响更小。

Objective:To investigate the influence of Sevoflurane on oxygen metabolism dynamics and cognitive function state in elderly patients with colorectal cancer surgery.Method:A total of 80 elderly patients with colorectal cancer surgery who treated in Fujian Provincial Hospital from October 2020 to December 2022 were divided into the control group 40 cases and the observation group 40 cases by the random number table method.The control group was treated with Propofol combined with Remifentanil,the observation group was treated with Sevoflurane combined with Remifentanil.Then the hemodynamics indexes[mean artery pressure(MAP)and heart rate(HR)],oxygen metabolism dynamics indexes[oxygen metabolism indexes:jugular bulb venous oxygen saturation(SjvO_(2))and jugular venous oxygen partial pressure(PjvO_(2));lactic acid indexes:lactic acid in venous blood(LacV)and lactic acid in arterial blood(LacA)]and cognitive function state[Montreal cognitive assessment(MoCA score);blood indexes of cognitive function indexes:S100B protein(S100B),neuron-specific enolase(NSE)and glutamate(Glu)]of two groups were compared.Result:There were no significant differences in hemodynamic indexes and oxygen metabolism kinetics indexes before anesthesia and preoperative cognitive function before operation between two groups(P>0.05);the hemodynamics indexes,oxygen metabolism dynamics indexes of the observation group at the beginning and end of surgery were significantly lower than those of the control group,the MoCA scores at 1 d and 3 d after operation were significantly higher than those of control group,and blood indexes of cognitive function indexes were significantly lower than those of control group,the differences were statistically significant(P<0.05).Conclusion:Sevoflurane can more effectively stabilize the hemodynamic status and oxygen metabolism kinetics of elderly patients with colorectal cancer surgery,and has less adverse effects on cognitive function.