全麻腹腔镜宫颈癌根治术中液体加温对患者应激状态、认知功能的影响  

The effect of liquid heating during laparoscopic radical cervical cancer surgery under general anesthesia on patients'stress state and cognitive function

作　　者：王茜 李斌[2] 马洪涛[1] 于瑶 代岱 Wang Qian;Li Bin;Ma Hongtao;Yu Yao;Dai Dai(Department of Anesthesiology,731 Hospital,China Aerospace Science and Industry Corporation,Beijing 100074;Department of Anesthesiology,Chinese Academy of Medical Sciences Tumor Hospital,Beijing 100021,P.R.China)

机构地区：[1]中国航天科工集团七三一医院麻醉科,北京100074 [2]中国医学科学院肿瘤医院麻醉科,北京100021

出　　处：《中国计划生育和妇产科》2024年第10期95-98,共4页Chinese Journal of Family Planning & Gynecotokology

基　　金：北京市卫生科技发展专项基金(项目编号:2020-4-217)。

摘　　要：目的研究全麻腹腔镜宫颈癌根治术中液体加温对患者应激状态、认知功能的影响。方法选取2021年1月至2022年12月于中国航天科工集团七三一医院择期行宫颈癌根治术的120例患者,随机数字表法将患者分为对照组和研究组,各60例。对照组术中采用常规干预,研究组术中通过液体加温控制体温,比较两组术中各时间点(术中1 h、2 h、3 h、手术结束时)体温变化、术后苏醒质量(拔管时间、完全清醒时间)、应激指标[丙二醛(MDA)、谷胱甘肽过氧化物酶(GSH-Px)、超氧化物歧化酶(SOD)]水平、认知功能[简易智力状态检测量表(MMSE)评分]及细胞免疫指标(CD3^(+)、CD4^(+))。结果对照组术中1 h、2 h、3 h、手术结束时低体温分别发生15例、26例、32例、38例,研究组分别发生6例、10例、12例、16例,研究组低体温发生率均低于对照组(P<0.05)。研究组术后拔管时间[(18.14±1.64)min]、完全清醒时间[(43.05±4.08)min]短于对照组[(21.56±2.79)min、(58.43±6.11)min](P<0.05)。手术前,两组血清SOD、MDA、GSH-Px、CD3^(+)、CD4^(+)、MMSE评分差异无统计学意义(P>0.05);与手术前比较,两组术后24 h血清MDA显著升高(P<0.05),GSH-Px、SOD、CD3^(+)、CD4^(+)显著降低(P<0.05),但对照组术后24 h血清MDA升高幅度以及GSH-Px、SOD、CD3^(+)、CD4^(+)降低幅度更大(P<0.05)。与手术前比较,两组术后24 h、72 h的MMSE评分均明显下降,但研究组术后24 h、72 h的MMSE评分显著高于对照组(P<0.05)。结论术中液体加温技术能有效减少全麻腹腔镜宫颈癌根治术患者术中与术后低体温情况,促进术后苏醒,减轻应激反应并提高认知功能与免疫功能,为切实有效的一项干预措施。Objective To study the effect of liquid heating during laparoscopic radical cervical cancer surgery under general anesthesia on patients'stress state and cognitive function.Method 120 patients who underwent elective cervical cancer radical surgery at China Aerospace Science and Industry Group 731 Hospital from January 2021 to December 2022 were selected and randomly divided into a control group and a study group,with 60 patients in each group,using a random number table method.The control group received routine intervention during surgery,while the study group used liquid heating to control body temperature during surgery.The temperature changes at various time points during surgery(1 hour,2 hours,3 hours,and at the end of surgery),postoperative recovery quality(extubation time,complete wakefulness time),stress indicators[malondialdehyde(MDA),glutathione peroxidase(GSH Px),superoxide dismutase(SOD)]levels,cognitive function[Mini Mental State Examination(MMSE)score],and cellular immune indicators(CD3^(+),CD4^(+))were compared between the two groups.Results There were 15 cases,26 cases,32 cases,and 38 cases of hypothermia at 1 hour,2 hours,3 hours during surgery,and at the end of surgery in the control group,respectively.There were 6 cases,10 cases,12 cases,and 16 cases in the study group,respectively.The incidence of hypothermia in the study group was lower than that in the control group(P<0.05).The postoperative extubation time[(18.14±1.64)minutes]and complete awakening time[(43.05±4.08)minutes]in the study group were shorter than those in the control group[(21.56±2.79)minutes,(58.43±6.11)minutes](P<0.05).Before surgery,there was no statistically significant difference in serum SOD,MDA,GSH-Px,CD3^(+),CD4^(+),and MMSE scores between the two groups(P>0.05).Compared with before surgery,serum MDA significantly increased(P<0.05)and GSH-Px,SOD,CD3^(+),and CD4^(+)significantly decreased(P<0.05)in both groups at 24 hours after surgery.However,the control group had a greater increase in serum MDA at 24 hours after sur

关 键 词：宫颈癌 全麻腹腔镜根治术 液体加温 应激状态 认知功能 

分 类 号：R711.74[医药卫生—妇产科学]