右美托咪定对脓毒症患者注意网络功能的影响  

Effects of dexmedetomidine on attention network function in patients with sepsis

作　　者：王杰 周玉梅[1] 李元海[2] WANG Jie;ZHOU Yumei;LI Yuanhai(Department of Anesthesiology,Yijishan Hospital of Wannan Medical College,Wuhu 241000,Anhui,China;Department of Anesthesiology,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,Anhui,China)

机构地区：[1]皖南医学院弋矶山医院麻醉科,安徽芜湖241000 [2]安徽医科大学第一附属医院麻醉科,安徽合肥230022

出　　处：《贵州医科大学学报》2023年第10期1238-1243,共6页Journal of Guizhou Medical University

基　　金：皖南医学院中青年科研基金项目(WK2018F19)。

摘　　要：目的探讨右美托咪定对脓毒症患者术后早期注意网络功能的影响。方法脓毒症患者40例随机均分为右美组(常规麻醉+右美托咪定麻醉)和非右美组(常规麻醉),收集2组患者的一般资料;采用E·prime编程进行注意网络测试(ANT)实验,检测2组脓毒症患者术后第5、10天G注意网络效率,并于术前、术后第5天取患者静脉血检测血清肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、核因子-κB(NF-κB)、乳酸、谷丙转氨酶(ALT)、肌酐(Cr)。结果2组脓毒症患者的性别、受教育时间、简易精神状态检查(MMSE)评分、体质量指数(BMI)、年龄、ASA分级、合并症、手术和麻醉时间比较,差异无统计学意义(P>0.05);术后第5天,右美组脓毒症患者的警觉、定向注意功能高于非右美组,执行控制及视觉模拟评分(VAS)评分低于非右美组(P<0.05);术后第10天,2组脓毒症患者警觉、定向的注意功能较术后第5天均升高,右美组高于非右美组(P<0.05),反应时间及VAS评分较术后第5天降低(P<0.05),非右美组执行控制较术后第5天降低,术后第10天右美组执行控制低于非右美组(P<0.05)。术后第5天,2组患者血清TNF-α、IL-6及NF-κB水平低于术前,右美组低于非右美组(P<0.05)。术后第5天,两组患者血清乳酸、ALT、Cr水平低于术前,右美组低于非右美组(P<0.05)。结论右美托咪定有助于脓毒症患者的早期注意网络的恢复,同时降低机体炎症反应,改善患者机体代谢。Objective To investigate the effect of dexmedetomidine on early postoperative attention network function in patients with sepsis.Methods A total of 40 patients with sepsis were divided into dexmedetomidine group(routine anesthesia+dexmedetomidine anesthesia)and the non-dexmedetomidine group(routine anesthesia),and general information of patients was collected.The E·prime programming was used attention network test(ANT)to detect the efficiency of G attention network on the 5 th and 10 th d after operation in both groups of sepsis patients.Serum tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),nuclear factor-κB(NF-κB),lactic acid,alanine aminotransferase(ALT),and creatinine(Cr)were detected in venous blood samples before and on the 5 th d after surgery.Results There was no statistically significant differences in gender,education time,MMSE score,body mass index(BMI),age,ASA grading,comorbidities,surgical and anesthesia time between both groups of sepsis patients(P>0.05).On the 5 th d after surgery,the alert and directed attention function of dexmedetomidine group was higher than that of non-dexmedetomidine group,and the executive control and visual analog scale(VAS)scores were lower than those of non-dexmedetomidine group(P<0.05).On the 10 th d after surgery,the alert and directed attention function of sepsis patients in both groups was higher than that on the 5 th d after surgery,dextral group was higher than those in the non-dextral group(P<0.05);the response time and VAS score were lowered on the 5 th day after surgery(P<0.05),and the executive control in the non-dextral group was lower than that on the 5 th d after surgery,the executive control of dexmedetomidine group was lower than that of non-dexmedetomidine group on the 10 d after surgery(P<0.05).On the 5 th d after surgery,serum levels of TNF-α,IL-6,and NF-κB in both groups were lower than before surgery,and dexmedetomidine group was lower than non-dexmedetomidine group(P<0.05).On the 5 th d after surgery,the serum levels of lactic acid,ALT and Cr

关 键 词：脓毒症 右美托咪定 注意网络测试 注意网络效率 炎症指标 代谢指标 麻醉 

分 类 号：R979.1[医药卫生—药品]