经皮穴位电刺激对老年患者腹腔镜直肠癌切除术后认知功能的影响研究  

Effect of Transcutaneous Acupoint Electrical Stimulation on Postoperative Cognitive Function in Elderly Patients Undergoing Laparoscopic Resection of Rectal Cancer

作　　者：倪剑武[1] 蒋柳明[2] 周一敏[1] 莫云长[2] 吴群[2] 王均炉[2] 

机构地区：[1]浙江省温州市中医院麻醉科,325000 [2]温州医科大学附属第一医院麻醉科

出　　处：《中国全科医学》2015年第12期1390-1395,共6页Chinese General Practice

基　　金：国家自然科学基金资助项目(81273926);国家重点基础研究发展计划973计划(2013CB531900)

摘　　要：目的探讨经皮穴位电刺激(TAES)对老年患者腹腔镜直肠癌切除术后认知功能的影响及其可能的机制。方法选择2011年6月—2014年5月温州医科大学附属第一医院肿瘤外科收治的腹腔镜下直肠癌Dixon手术的老年患者60例,采用随机数字表法分为对照组30例和TAES组30例。两组患者均选择全凭静脉麻醉,TAES组患者麻醉诱导前30 min至术毕加用TAES进行干预。在围术期使用精神状态简易速检表(MMSE)对患者认知功能进行评分,并在不同时间点检测患者血清超氧化物歧化酶(SOD)、丙二醛(MDA)、S100β水平。结果 MMSE评分治疗方法与时间无交互作用(P>0.05);组间比较,差异有统计学意义(P<0.05);时间间比较,差异有统计学意义(P<0.05)。术后1、3、5 d TAES组MMSE评分高于对照组(P<0.05)。术后1、3 d TAES组患者POCD严重程度低于对照组(P<0.05),术后5、7 d两组患者POCD严重程度比较,差异无统计学意义(P>0.05)。SOD、MDA、S100β水平治疗方法与时间无交互作用(P>0.05);组间比较,差异有统计学意义(P<0.05);时间间比较,差异有统计学意义(P<0.05)。术毕,术后2、6、24 h TAES组SOD水平高于对照组(P<0.05);术后2、6、24 h TAES组MDA、S100β水平低于对照组(P<0.05)。结论老年患者腹腔镜直肠癌切除导致术后认知功能障碍,TAES通过增加SOD水平、抑制MDA聚集、减少S100β释放,保护脑功能,可以明显减少患者术后认知功能障碍的发生。Objective To observe the effect of transcutaneous acupoint electrical stimulation（ TAES） on postoperative cognitive function in elderly patients undergoing laparoscopic resection of rectal cancer and its possible mechanism. Methods Sixty elderly patients with rectal cancer who underwent laparoscopic Dixon surgery in Department of Surgical Oncology in the First Hospital Affiliated to Wenzhou Medical University from June 2011 to May 2014,were randomly divided into TAES group（ group E,30 cases） and control group（ group C,30 cases） by random number table method. Total intravenous anesthesia were selected for patients of two groups,group E were continually treated with TASE from 30 minutes before anesthesia to the end of operation. The mini-mental state examination（ MMSE） was used to evaluate the changes of cognitive function during the perioperative period, serum levels of superoxide dismutase（ SOD）, malondialdehyde（ MDA） and S100β were detected at different time points. Results There was no significant interaction between treatment method and time（ P〈0. 05）; there were significant differences in MMSE scores among groups（ P〈0. 05）; there were significant differences in MMSE scores among different time points（ P〈0. 05）; MMSE scores 1,3,5 days after operation in group E were significantly higher than those ingroup C respectively（ P〈0. 05）. The severity degree of POCD 1,3 days after operation of patients in group E were significantly lower than those in group C respectively（ P〈0. 05）. There was no significant difference in severity degree of POCD 5,7 days after operation between two groups（ P〈0. 05）. There was no significant interaction between treatment method and time（ P〉0. 05）; there were significant differences in serum levels of SOD, MDA and S100β among groups（ P〈0. 05）; there were significant differences in serum levels of SOD,MDA and S100β among different time points（ P〈0. 05）. The levels of SOD in group E were higher than those in g

关 键 词：结直肠肿瘤 认知障碍 腹腔镜检查 电刺激疗法 

分 类 号：R735.37[医药卫生—肿瘤]