右美托咪定对高龄患者腹腔镜下结肠癌术后早期认知功能的影响  

Effects of Dexmedetomidine on Early Cognitive Function after Laparoscopic Colonic Surgery in Elderly Patients

作　　者：苑汐子[1] 党长宁[1] 孙凤伟 王永[1] 张喻然 YUAN Xizi;DANG Changning;SUN Fengwei;WANG Yong;ZHANG Yuran(The Fifth Department of Anorectal,the Third Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang,Liaoning,110000,China)

机构地区：[1]辽宁中医药大学附属三院肛肠五科,辽宁沈阳110000

出　　处：《肿瘤药学》2018年第3期411-414,共4页Anti-Tumor Pharmacy

摘　　要：目的探讨右美托咪定对高龄患者腹腔镜下结肠癌术后早期认知功能的影响。方法选择本院收治的需行手术治疗的高龄结肠癌患者80例,随机分为观察组与对照组,各40例。对照组术后行常规镇痛治疗,观察组在对照组基础上术后持续静脉泵入右美托咪定。比较两组干预后CD4^+、CD8^+、CD4^+/CD8^+及免疫球蛋白水平,血浆S-100B蛋白及NSE水平,以及干预后ESS、MMSE评分。结果干预后观察组CD4^+、CD8^+、CD4^+/CD8^+及IgM、IgG、IgA水平均显著高于对照组(P<0.05),血浆S-100B蛋白及NSE水平均显著低于对照组(P<0.05),ESS、MMSE评分显著高于对照组(P<0.05)。结论针对腹腔镜下结肠癌手术高龄患者,术后使用右美托咪定能有效提高机体免疫功能及术后神经系统功能,减少术后认知功能障碍。Objective To investigate the effect of dexmedetomidine on early cognitive function after laparoscopic colonic surgery in elderly patients.Methods 80 patients with advanced colorectal cancer were randomly divided into observation group and control group,40 cases in each group.Forty patients in control group were treated with routine analgesia.And those in observation group were intravenously pumped with dexmedetomidine continuously on the basis of the control group after surgery.The levels of CD4+,CD8+,CD4+/CD8+,immunoglobulin,plasma S-100B protein,NSE,ESS,MMSE score changes were compared between the two groups.Results After treatment,the levels of CD4+,CD8+and CD4+/CD8+of patients in observation group was higher than in control group(P<0.05).The levels of IgM,IgG and IgA of patients in observation group were also higher than in control group(P<0.05).The levels of plasma S-100B protein and NSE of patients in observation group were lower than in the control group(P<0.05).The scores of ESS and MMSE of the observation group were higher than those of the control group(P<0.05).Conclusion For the elderly patients undergoing laparoscopic colorectal cancer surgery,postoperative use of dexmedetomidine can effectively improve the immune function and postoperative neurological function,reduce postoperative cognitive dysfunction.

关 键 词：右美托咪定 高龄 腹腔镜结肠癌手术 认知功能 

分 类 号：R735.35[医药卫生—肿瘤]