老年全麻患者术后血浆硫化氢水平与术后认知功能障碍的关系  

Association of Hydrogen Sulfide Level with Postoperative Cognitive Dysfunction in Elderly Patients After General Anesthesia

作　　者：何庆标[1] 黄威[1] 王育明[1] 詹长春[1] 

机构地区：[1]武警广东省总队医院麻醉科,广东广州510507

出　　处：《黑龙江医学》2017年第7期599-601,共3页Heilongjiang Medical Journal

基　　金：广东省医学科学技术研究基金项目(B2016041)

摘　　要：目的探讨老年全麻患者术后血浆硫化氢(H_2S)水平的变化与术后认知功能障碍(POCD)发生的关系。方法选择2016-07—2016-11间在武警广东省总队医院麻醉科择期全麻手术老年患者60例,于麻醉诱导前(T0)、手术结束时(T1)、术后24h(T2)、48h(T3)和72 h(T4)时采集桡动脉血标本测定血浆H_2S浓度。采用蒙特利尔认知评估表(Mo CA)评分于术前1 d、术后1~3 d评价患者的认知功能。结果术后3d的期间,有15例发生POCD(25%)。与T0比较,POCD组T2、T3各时点血浆H_2S浓度降低(P<0.05),T4时恢复;与非POCD组比较,POCD组T2、T3各时点血浆H_2S浓度降低(P<0.05)。POCD组血浆H_2S浓度与Mo CA评分呈显著正相关(r=0.86,P<0.01)。结论老年全麻患者术后血浆H_2S水平降低可能参与了POCD发生的病理生理过程。Objective To investigate the relationship of hydrogen sulfide level with postoperative cognitive dysfunction in elderly patients after general anesthesia. Methods 60 elderly patients had general anesthesia in the hospital from July,2016 to November,2016 were researched. The blood samples were taken before anesthesia（ T0,baseline）,at the end of operation（ T1） and 24（ T2）,48（ T3） and 72 h（ T4） after operation for measurement of hydrogen sulfide. The cognitive function was evaluated by Mo CA on 1d before operation and on 1 ~ 3d after operation. Results 15 patients had POCD（ 25%）. At T2、T3,hydrogen sulfide level were significantly lower than that at T0. Hydrogen sulfide level in POCD patients were significantly lower than in n-POCD at T2,T3.The hydrogen sulfide level were positive correlated with Mo CA score（ r = 0. 86,P〈0. 01）. Conclusion Elderly patients may develop POCD after operation performed under general anesthesia through decrease in intracranial hydrogen sulfide levels.

关 键 词：老年患者 全麻 硫化氢 认知功能障碍 

分 类 号：R614[医药卫生—麻醉学] R749.2[医药卫生—外科学]