术前应用依达拉奉对低体质量老年患者全麻术后谵妄的预防作用  

Preventive effect of preoperative application of edaravone for delirium in low-weight elderly patients

作　　者：潘中心[1] 徐玲[1] 

机构地区：[1]衢州市人民医院麻醉科,浙江衢州324000

出　　处：《中国生化药物杂志》2016年第10期80-83,共4页Chinese Journal of Biochemical Pharmaceutics

摘　　要：目的探讨术前应用依达拉奉对低体质量老年患者全麻术后谵妄的预防作用。方法选取2013年11月-2016年4月衢州市人民医院择期腹部全麻低体质量（BMI〈18.5）老年患者56例,按随机数字表法分为研究组和对照组,各28例,研究组术前静脉输注依达拉奉30 mg,对照组术前予以等容量生理盐水,于麻醉诱导前（T0）、术后1d（T1）、术后2 d（T2）和术后3d（T3）测定血液学指标,同时对比术后谵妄和不良反应状况。结果相对于T0,2组手术后T1、T2、T3时IL-6、TNF-α含量升高,T1、T2时超氧化物歧化酶（superoxide dismutase,SOD）降低,丙二醛（malonaldehyde,MDA）升高,T1、T2、T3时神经原特异性烯醇化酶（neuron-specific enolase,NSE）、S100β蛋白（s-βprotein,S100β）升高,T1、T2时简易智力状态量表（Mini Mental State Examination,MMSE）评分、蒙特利尔认知评估量表（Montreal Cognitive Assessment,Mo CA）评分降低差异均具有统计学意义（P〈0.05）;相对于对照组,研究组手术后T1、T2、T3时IL-6、TNF-α含量较低,T1、T2、T3时SOD较高,MDA较低,T1、T2、T3时NSE、S100β较低,T1、T2、T3时MMSE、Mo CA评分较高,差异均具有统计学意义（P〈0.05）;研究组T1、T2时谵妄发生率低于对照组（P〈0.05）。结论术前应用依达拉奉能抑制低体质量全麻老年患者氧化应激和炎症反应,降低术后谵妄和认知功能障碍发生率。Objective To investigate the preventive effect of ravings of edaravone preoperativeapplication in Low weight elderly patients. Methods56 cases of elderly patients form November 2013 to April 2016 in our hospital with low weight（ BMI 18. 5） who were scheduled for abdominal operation were selected and randomly divided into experiment group and control group,28 cases in each group. The experiment group received edaravone 30 mg preoperative application,and the control group received equal volume physiological saline. Hematology index were compared at before anesthesia induction（ T0）,postoperative one day（ T1）,postoperative two day（ T2） and postoperative three day（ T3）,and postoperative delirium and adverse reaction conditions were also compared after the operation. Results Compared with T0,serum IL-6 and TNF-α increased in 2 groups at T1,T2 and T3,serum SOD decreased and MDA increased at T1,T2,levels of NSE and S100β increased at T1,T2 and T3,MMSE and Mo CA score decreased at T1,T2（ P〈0. 05）. Compared with the control group,serum IL-6 and TNF-α in the experiment group at T1,T2 and T3 were lower,serum SOD were higher,and MDA were lower,and levels of NSE and S100β were lower at T1,T2 and T3,MMSE and Mo CA score were higher,the difference was statistically significant（ P〈0. 05）,and the incidence of delirium in the experiment group was lower than the control group（ P〈0. 05）. Conclusion Preoperative application of edaravone in low-weight elderly patients can inhibit the oxidative stress and inflammation,reduce postoperative delirium and cognitive dysfunction.

关 键 词：依达拉奉 低体重老年患者 BMI<18.5 全麻 术后谵语 

分 类 号：R614[医药卫生—麻醉学]