右美托咪定辅助全身麻醉对结肠癌合并肠梗阻患者围术期脑保护的影响分析

Analysis of the effect of dexmedetomidine-assisted general anesthesia on perioperative brain protection in patients with colon cancer complicated with intestinal obstruction

目的分析右美托咪定辅助全身麻醉对结肠癌合并肠梗阻患者围术期脑保护的影响。方法120例行手术治疗的结肠癌合并肠梗阻患者,采用随机数字表法将其分为观察组和对照组,每组60例。对照组予以常规静脉吸入复合麻醉,观察组采用右美托咪定辅助全身麻醉。比较两组患者手术前后的简易智力状态检查量表(MMSE)评分以及S100-β蛋白、神经元特异性烯醇化酶(NSE)、白细胞介素(IL)-10、干扰素-γ(INF-γ)、IL-2水平。结果术后1、3 d,观察组MMSE评分分别为(27.61±0.21)、(28.12±0.23)分,均高于对照组的(24.14±0.42)、(26.02±0.15)分,差异有统计学意义(P<0.05)。术后24 h,两组S100β蛋白、NSE水平均有所升高,但相较于对照组的(103.52±8.92)μg/L、(8.92±0.27)ng/ml,观察组的S100β蛋白(72.36±8.25)μg/L、NSE(6.12±0.24)ng/ml更低,差异有统计学意义(P<0.05)。术后24 h,观察组INF-γ(49.82±2.93)pg/ml高于对照组的(39.85±3.15)pg/ml,IL-10(13.93±3.82)pg/ml、IL-2(25.92±6.25)pg/ml低于对照组的(18.92±4.95)、(37.95±7.19)pg/ml,差异具有统计学意义(P<0.05)。结论右美托咪定辅助全身麻醉应用于结肠癌合并肠梗阻手术治疗中具有良好的镇静、镇痛效果,可以使其术中血流动力学稳定,有效保护脑细胞,降低炎症反应,进一步减少脑组织损伤,具有较好的脑保护作用,可减少认知功能损伤,具有较高应用价值。

Objective To analyze the effect of dexmedetomidine-assisted general anesthesia on perioperative brain protection in patients with colon cancer complicated with intestinal obstruction.Methods 120 patients with colon cancer complicated with intestinal obstruction were divided into an observation group and a control group according to random numerical table,with 60 patients in each group.The control group was given conventional intravenous inhalation combined anesthesia,and the observation group was given dexmedetomidine assisted general anesthesia.The scores of mini-mental state examination(MMSE),serum S100βprotein,neuron-specific enolase(NSE),interleukin-10,interferon-γ(INF-γ),and IL-2 levels before and after operation were compared between the two groups.Results 1 and 3 d after operation,MMSE scores in the observation group were(27.61±0.21)and(28.12±0.23)points,which were higher than(24.14±0.42)and(26.02±0.15)points in the control group,and the difference was statistically significant(P<0.05).24 h after operation,S100βprotein and NSE levels in both groups were increased;the observation group had S100βprotein of(72.36±8.25)μg/L and NSE of(6.12±0.24)ng/ml,which were lower than(103.52±8.92)μg/L and(8.92±0.27)ng/ml in the control group;the difference was statistically significant(P<0.05).24 h after operation,INF-γwas(49.82±2.93)pg/ml in the observation group,which was higher than(39.85±3.15)pg/ml in the control group;the observation group had IL-10 of(13.93±3.82)pg/ml and IL-2 of(25.92±6.25)pg/ml,which were lower than(18.92±4.95)and(37.95±7.19)pg/ml in the control group;the difference was statistically significant(P<0.05).Conclusion Dexmedetomidine-assisted general anesthesia has a good sedative and analgesic effect in colon cancer complicated with intestinal obstruction,which helps to stabilize hemodynamics during operation,effectively protect brain cells,reduce inflammatory reaction,further reduce brain tissue damage,and has a good brain protection effect,which can reduce cognitive function damage,and has high application value.