右美托咪定联合术中保温对结直肠癌根治术患者缺氧性脑损伤及细胞免疫的影响  

Effects of Dexmedetomidine combined with intraoperative warming on hypoxic brain injury and cellular immunity in patients undergoing radical resection of colorectal cancer

作　　者：宋小涛 李明晖 冯海红[2] 郭飞[2] 姚杰[3] 武雪亮[2] SONG Xiaotao;LI Minghui;FENG Haihong;GUO Fei;YAO Jie;WU Xueliang(Operating Room,the First Affiliated Hospital of Hebei North University,Hebei Province,Zhangjiakou 075000,China;Department of General Surgery,the First Affiliated Hospital of Hebei North University,Hebei Province,Zhangjiakou075000,China;Department of Anesthesiology,the First Affiliated Hospital of Hebei North University,Hebei Province,Zhangjiakou075000,China)

机构地区：[1]河北北方学院附属第一医院手术室,河北张家口075000 [2]河北北方学院附属第一医院普通外科,河北张家口075000 [3]河北北方学院附属第一医院麻醉科,河北张家口075000

出　　处：《中国医药导报》2022年第19期169-173,共5页China Medical Herald

基　　金：河北省卫生和计划生育委员会医学科学研究重点课题计划项目(20180863)。

摘　　要：目的探讨术中结合综合保温护理对结直肠癌根治术患者缺氧性脑损伤及细胞免疫的影响。方法选择2019年3月至2020年3月在河北北方学院附属第一医院行直肠癌根治术患者100例作为研究对象。采用随机数字表法将其分为两组,每组50例。对照组给予右美托咪定治疗,行常规护理,观察组给予右美托咪定结合综合术中保温护理干预。比较两组术前,术后1、3 d简明智能状态量表(MMSE)评分、细胞免疫功能、白细胞介素-6(IL-6)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)变化,统计两组术后认知功能障碍(POCD)及并发症发生情况。结果术前,两组MMSE评分比较,差异无统计学意义(P>0.05);对照组术后1、3 d MMSE评分低于术前,差异有统计学意义(P<0.05);术后1、3 d观察组MMSE评分均高于对照组,差异有统计学意义(P<0.05)。术前,两组CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)比较,差异无统计学意义(P>0.05);两组术后1、3 d CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)低于术前,差异有统计学意义(P<0.05);术后1、3 d,观察组CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)均高于对照组,差异有统计学意义(P<0.05)。术前,两组IL-6、TNF-α、CRP比较,差异无统计学意义(P>0.05);两组术后1、3 d IL-6、TNF-α、CRP高于术前,差异有统计学意义(P<0.05);术后1、3 d,观察组IL-6、TNF-α、CRP均低于对照组,差异有统计学意义(P<0.05)。术后1、3 d,观察组POCD发生率低于对照组,差异有统计学意义(P<0.05)。观察组并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论综合术中保温护理干预结直肠癌根治术患者效果理想,可有促进患者认知功能恢复,减轻患者细胞免疫抑制状态及炎症因子分泌,进而降低POCD及并发症发生率。Objective To explore the effect of comprehensive intraoperative warming nursing on hypoxic brain injury and cellular immunity in patients undergoing radical resection of colorectal cancer.Methods A total of 100 patients who undergoing radical resection of rectal cancer in the First Affiliated Hospital of Hebei North University from March 2019 to March 2020 were selected as the research subjects.The patients were divided into two groups by random number table method,with 50 cases in each group.The control group was given Dexmedetomidine,and the observation group was given Dexmedetomidine combined with comprehensive intraoperative warming nursing intervention.The scores of mini-mental state scale(MMSE),cellular immune function,interleukin-6(IL-6),C-reactive protein(CRP),the change of tumor necrosis factor-α(TNF-α),the post-operative cognitive dysfunction(POCD),and complications of the two groups were counted.Results Before surgery,there was no significant difference in MMSE score between the two groups(P>0.05).The MMSE scores of the control group one and three days after operation were lower than those before operation,and the differences were statistically significant(P<0.05).MMSE scores of observation group were higher than control group one and three days after operation,the differences were statistically significant(P<0.05).Before surgery,there were no significant differences in CD4^(+),CD8^(+),CD4^(+)/CD8^(+)between the two groups(P>0.05).One and threee days after operation,CD4^(+),CD8^(+),and CD4^(+)/CD8^(+)were lower than those before operation,the differences were statistically significant(P<0.05).One and three days after operation,CD4^(+),CD8^(+),and CD4^(+)/CD8^(+)in the observation group were higher than those in the control group,the differences were statistically significant(P<0.05).Before operation,there were no significant differences in IL-6,TNF-α,and CRP between the two groups(P>0.05).One and three days after operation,IL-6,TNF-α,and CRP in two groups were significantly higher than those before

关 键 词：结直肠癌 综合术中保温护理 细胞免疫 炎症因子 并发症 

分 类 号：R735.3[医药卫生—肿瘤]