Dex术中应用对老年胃癌根治术患者血清S100B、NSE及炎性指标的影响  

Effect of DEX on Serum S100B and NSE in Elderly Patients Undergoing Radical Gastrectomy and Inflammatory Index

作　　者：高媛媛[1] 闫飞 GAO Yuan-yuan;YAN Fei(Department of Anesthesia and Surgery,Yulin Second Hospital,Yulin Shaanxi,719000)

机构地区：[1]榆林市第二医院麻醉手术科,陕西榆林719000 [2]榆林市中医医院麻醉科,陕西榆林719000

出　　处：《医学临床研究》2021年第2期202-205,共4页Journal of Clinical Research

摘　　要：【目的】探讨全麻下老年胃癌根治术中右美托咪定(Dex)的应用对患者血清S1OOB蛋白(S100B)、神经元特异性烯醇化酶(NSE)及炎性指标的影响。【方法】选取本院在同一组医护人员管理下拟实施腹腔镜胃癌根治术的患者96例作为研究对象,依据就诊顺序随机分为Dex组、对照组各48例。两组均采用气管插管下静脉全麻,Dex组同时果入0.5 mL/kg Dex,15 min杲完,泵入等量的生理盐水。对比两组患者手术前、术后山、术后d3的简易精神状态量表(MMSE)评分、术前及术后24 h血清S100B、NSE、肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、C反应蛋白(CRP)及不良反应发生率。【结果】两组患者术前血清S100B、NSE、TNF-α、IL-1β、CRP水平比较差异均无统计学意义(P>0.05)。术前至术后3 d两组患者MMSE评分比较,差异具有统计学意义(P<0.05),而术后山对照组的MMSE评分明显降低。术后24 h,Dex组患者的血清S100B、NSE、TNF-α、IL-1β、CRP水平均显著低于对照组,差异具有统计学意义(P<0.05)。Dex组患者的不良反应发生率明显低于对照组,差异具有统计学意义(8.33% vs 25.00%,χ2=4.800,P<0.05)。【结论】Dex在全麻下老年胃癌根治术患者中应用有利于减轻手术引起的认知功能损害和炎症应激反应,同时可降低患者不良反应发生率。[Objective]To explore the effect of the application of dexmedetomidine(Dex)on the serum SlOOB protein(S100B),neuron-specific enolase(NSE)and inflammatory indexes during radical resection of gastric cancer in the elderly under general anesthesia.[Methods]A total of 96 patients with gastric cancer un­dergoing laparoscopic radical gastrectomy under the management of the same group of medical staff in our hos­pital were randomly divided into DEX group and control group,48 cases in each group.Both groups were given intravenous anesthesia under tracheal intubation,In the Dex group,0.5 ml/kg DEX was pumped at the same time,and the same amount of normal saline was pumped after 15 minutes.The MMSE scores,serum S1OOB 24 hours preoperative and postoperative,NSE,tumor necrosis factor-α(TNF-α)-interleukin-1β(IL-1β),C-reactive protein(CRP)and the incidence of adverse reactions were compared between the two groups before operation,1 and 3 days after operation.[Results]There was no significant difference in preoperative serum S100B,NSE,TNF-α.IL-1β and CRP levels between the two groups(P>0.05).The difference of MMSE score between the two groups before and 3 days after operation was statistically significant(P<0.05),while the MMSE score of the control group was significantly lower on I day after operation.At 24 hours after opera­tion.the serum levels of S100B,NSE,TNF-α,IL-1β and CRP in the Dex group were significantly lower than those in the control group(P<0.05).The incidence of adverse reactions in dex group was significantly lower than that in control group(8.33% vs 25.00%,χ2=4.800,P<0.05).[Conclusion]Dex in elderly patients undergoing radical gastrectomy under general anesthesia can reduce the cognitive impairment and inflammatory stress reaction caused by surgery,and reduce the incidence of adverse reactions.

关 键 词：胃肿瘤/外科学 胃切除术 右美托咪啶/治疗应用 认知 白细胞介素6/血液 肿瘤坏死因子α/血液 

分 类 号：R735.2[医药卫生—肿瘤]