全身麻醉对行卵巢囊肿手术的围绝经期患者RBMT-Ⅲ评分及神经功能性因子水平的影响

Effect of general anesthesia on RBMT-Ⅲscores and neurofunctional factor levels in perimenopausal patients undergoing ovarian cyst surgery

目的探讨全身麻醉对行卵巢囊肿手术的围绝经期患者Rivermead行为记忆测验第3版(RBMT-Ⅲ)评分及神经功能性因子水平的影响。方法采用前瞻性研究方法,选取2021年1月至2023年4月在广州医科大学附属第三医院行卵巢囊肿手术的围绝经期患者92例作为观察组,同时选取行卵巢囊肿手术的非围绝经期患者92例作为对照组,两组均接受全身麻醉和卵巢囊肿腹腔镜手术治疗。观察两组手术时间、麻醉时间、气腹时间和苏醒时间以及麻醉诱导前、插管后、气腹建立后和苏醒时心率、平均动脉压(MAP)和血氧饱和度(SpO_(2)),以及麻醉前、麻醉后3 d两组患者RBMT-Ⅲ总分和神经功能性因子[血清S100钙结合蛋白B(S100B)、5-羟色胺(5-HT)、γ-氨基丁酸(GABA)和脑源性神经营养因子(BDNF)]水平。结果观察组和对照组手术时间、麻醉时间、气腹时间和苏醒时间比较,差异均无统计学意义(P>0.05);两组插管后、气腹建立后和苏醒时心率较麻醉诱导前均降低,两组插管后、气腹建立后MAP较麻醉诱导前均降低,差异均有统计学意义(P<0.05),两组插管后、气腹建立后和苏醒时SpO_(2)与麻醉诱导前比较,组内差异均无统计学意义(P>0.05)。两组麻醉诱导前、插管后、气腹建立后和苏醒时心率、MAP和SpO_(2)组间比较,差异均无统计学意义(P>0.05)。麻醉后3 d,观察组RBMT-Ⅲ总分为(71.65±10.41)分,明显低于对照组[(92.24±9.97)分],差异有统计学意义(P<0.05)。麻醉后3 d,观察组的S100B水平为(0.68±0.11)ng/mL,明显高于对照组[(0.55±0.12)ng/mL],差异有统计学意义(P<0.05);两组5-HT、GABA和BDNF水平比较,差异均无统计学意义(P>0.05)。结论相比较卵巢囊肿手术的非围绝经期患者,全身麻醉对围绝经期患者术后记忆功能及神经功能性因子S100B有明显影响,应更加注重围手术期麻醉管理。

Objective To explore the effect of general anesthesia on the Rivermead behavioral memory test third edition(RBMT-Ⅲ)scores and levels of neurofunctional factors in perimenopausal patients undergoing ovarian cyst surgery.Methods Prospective study method was used and 92 perimenopausal patients who underwent ovarian cyst surgery in the Third Affiliated Hospital of Guangzhou Medical University from January 2021 to April 2023 were selected as the observation group,and 92 non-perimenopausal patients who underwent ovarian cyst surgery were selected as the control group.Both groups received general anesthesia and laparoscopic surgery for ovarian cysts.The surgical time,anesthesia time penumoperitoneum time and recovery time as well as the heart rate,mean arterial pressure(MAP),and oxygen saturation(SpO_(2))before anesthesia indution,after intubation,after penumoperitoneum establishment and recovery time of the two groups were observed,and the RBMT-Ⅲtotal score and levels of neurofunctional factors[S100 calcium blinding protein B(S100B),5-hydroxytryptamine(5-HT),γ-aminobutyric acid(GABA)and brain derived neurotrophic factor(BDNF)]before anesthesia and 3 days after anesthesia were analyzed.Results There were no statistically significant differences in surgical time,anesthesia time,pneumoperitoneum time,and recovery time between the observation group and the control group(P>0.05).The heart rate after intubation,establishment of pneumoperitoneum and awakening in the observation group and the control group were lower than those before anesthesia induction.The MAP after intubation and establishment of pneumoperitoneum in both groups were lower than those before anesthesia induction,and the differences were statistically significant(P<0.05).There were no statistically significant differences in SpO_(2)after intubation,establishment of pneumoperitoneum and awakening between the two groups and before anesthesia induction(P>0.05).There were no statistically significant differences in heart rate,MAP and SpO_(2)between the observation group and the control group before anesthesia induction,after intubation,after pneumoperitoneum establishment,and at awakening(P>0.05).The total score of RBMT-Ⅲwas(71.65±10.41)points in the observation group after anesthesia was significantly lower than that in the control group(92.24±9.97)points,the differences were statistically significant(P<0.05).At 3 days after anesthesia,S100B in the observation group was(0.68±0.11)ng/mL,which was significantly higher than that in the control group[(0.55±0.12)ng/mL],the differences were statistically significant(P<0.05);there were no statistically significant differences in 5-HT,GABA and BDNF between the observation group and the control group(P>0.05).Conclusion Compared with non-perimenopausal patients undergoing ovarian cyst surgery,general anesthesia has significant effects on postoperative memory function and neurofunctional factor S100B in perimenopausal patients,and more attention should be paid to perioperative anesthesia management.