硬膜外麻醉与全身麻醉对老年良性前列腺增生患者术后认知功能及外周炎性因子的影响

Effects of epidural anesthesia and general anesthesia on postoperative cognitive function and peripheral inflammatory factors in elderly patients with benign prostate hyperplasia

目的比较硬膜外麻醉与全身麻醉对老年良性前列腺增生(BPH)患者术后认知功能及外周炎性因子的影响。方法选取2020年1月至2022年12月于本院拟行手术治疗的80例老年BPH患者为研究对象,依据入院编号的奇偶性将其分为对照组和观察组,各40例。对照组行全身麻醉,观察组行硬膜外麻醉。比较两组患者的麻醉效果。结果术前(T_(0))~术后2 h(T_(4)),两组的平均动脉压(MAP)、心率(HR)无明显差异(P>0.05);手术开始30 min(T_(2))~T_(4),观察组的丙二醛(MDA)、超氧化物歧化酶(SOD)水平低于对照组(P<0.05)。术后24 h,观察组的简易智力状态检查量表(MMSE)评分高于对照组,白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)及C反应蛋白(CRP)水平低于对照组(P<0.05)。观察组的麻醉不良反应总发生率显著低于对照组(P<0.05)。结论相较于全身麻醉,硬膜外麻醉可显著改善老年BPH患者的创伤应激反应及术后炎症水平,同时可以降低认知功能受损程度,提升麻醉安全性。

Objective To compare the effects of epidural anesthesia and general anesthesia on postoperative cognitive function and peripheral inflammatory factors in elderly patients with benign prostate hyperplasia(BPH).Methods A total of 80 elderly patients with BPH who were scheduled to undergo surgical treatment in our hospital from January 2020 to December 2022 were selected as the research objects.According to the parity of admission number,and the patients were divided into control group and observation group,with 40 cases in each group.The control group received general anesthesia,and the observation group received epidural anesthesia.The anesthesia effects of the two groups were compared.Results Before surgery(T_(0))-2 h after surgery(T_(4)),there were no significant differences in mean arterial pressure(MAP)and heart rate(HR)between the two groups(P>0.05);at 30 min of surgery(T_(2))-T_(4),the levels of malondialdehyde(MDA)and superoxide dismutase(SOD)in the observation group were lower than those in the control group(P<0.05).At 24 h after operation,the Mini-Mental State Examination(MMSE)score of the observation group was higher than that of the control group,and the levels of interleukin-6(IL-6),interleukin-8(IL-8),tumor necrosis factor-α(TNF-α)and C-reactive protein(CPR)were lower than those of the control group(P<0.05).The total incidence of adverse reactions of anesthesia in the observation group was significantly lower than that in the control group(P<0.05).Conclusion Compared with general anesthesia,epidural anesthesia can significantly improve the traumatic stress response and postoperative inflammation level of elderly patients with BPH,reduce the degree of cognitive impairment and increase the safety of anesthesia.