围术期心理干预对老年开胸食管癌根治术患者术后认知功能的影响  

Effect of perioperative psychological intervention on postoperative cognitive function of elderly patients undergoing thoracotomy for esophageal cancer

作　　者：邓纯勇[1] 凌勇[1] 吴林举 DENG Chunyong;LING Yong;WU Lin-ju(Department of Anesthesia,Mianyang Third People's Hospital,Mianyang 621000,China)

机构地区：[1]绵阳市第三人民医院麻醉科

出　　处：《中国实用医药》2019年第26期107-109,共3页China Practical Medicine

摘　　要：目的观察围术期心理干预对老年开胸食管癌根治术患者术后认知功能的影响。方法140例拟行开胸食管癌根治术的老年患者,随机分为心理干预组和对照组,每组70例。心理干预组患者采取围术期心理干预措施,对照组患者采取常规术前访视。观察比较两组患者术后认知功能障碍(POCD)发生情况及手术前后血清中枢神经特异蛋白(S100β)与白细胞介素-6(IL-6)水平。结果术后第1、7天,心理干预组患者POCD发生率分别为38.6%、18.6%,均明显低于对照组的58.6%、35.7%,差异均有统计学意义(P<0.05)。术后第14天,心理干预组与对照组患者的POCD发生率分别为4.3%、5.7%,均明显低于术后第1、7天,差异均有统计学意义(P<0.05);但两组患者术后第14天POCD发生率比较,差异无统计学意义(P>0.05)。术后第1天,心理干预组患者血清S100β与IL-6水平分别为(102.65±15.15)、(36.42±4.35)ng/L,均明显低于对照组的(112.92±16.45)、(45.86±5.19)ng/L,且两组患者术后第1天血清S100p、IL-6水平均明显高于术前1d和术后第3天,差异均有统计学意义(P<0.05)。结论实施围术期心理干预能够明显降低老年开胸食管癌根治术患者POCD的发生风险,改善血清S100β及IL-6水平,值得临床推广。Objective To observe the effect of perioperative psychological intervention on postoperativecognitive function of elderly patients undergoing thoracotomy for esophageal cancer. Methods A total of140 elderly patients undergoing thoracotomy for esophageal cancer were randomly divided into psychologicalintervention group and control group, with 70 cases in each group. Psychological intervention group receivedperioperative psychological intervention, and the control group received conventional preoperative visits.Observation and comparison were made on occurrence of post-operative cognitive disorder (POCD), serumlevels of central nervous system specific protein (S100 β) and interleukin-6 (IL-6) before and after operation between the two groups. Results At lst and 7th day after operation, psychological intervention group hadobviously lower incidence of POCD as 38.6% and18.6% than 58.6% and 35.7% in the control group. Theirdifference was statistically significant (P<0.05). At 14th day after operation, psychological intervention groupand control group had obviously lower incidence of POCD respectively as 4.3% and 5.7% than those of 1st and7th day after operation, and their difference was statistically significant (P<0.05). But there was no statisticallysignificant difference in incidence of POCD at 14th day after operation between the, two groups (P>0.05). At lst .day after operation, psychological intervention group had obviously lower serum S100 ? and IL-6 respectivelyas (102.65 t 15.15) and (36.42 t 4.35) ng/L than (112.92 t 16.45) and (45.86 t 5.19) ng/L in the control group.Both groups had obviously higher serum levels ofS100β and IL--6 at 1st day after operation than those of 1st daybefore operation and 3rd day after operation, and their difference was statistically significant (P<0.05). ConclusionPerioperative psychological intervention can significantly reduce the risk of POCD in elderly patients undergoing?thoracotomy for esophageal cancer and improve the serum levels of S100β and IL-6. It is worthy of clini

关 键 词：心理干预 老年食管癌患者 认知功能 中枢神经特异蛋白 白细胞介素-6 

分 类 号：R473.73[医药卫生—护理学]