右美托咪定对行腹腔镜根治术的老年前列腺癌患者术后认知功能和氧化应激反应的影响  

Effects of dexmedetomidine on Oxidative stress and cognitive postoperative function in elderly patients with prostate cancer undergoing laparoscopic radical surgery

作　　者：金楠 丁春棉 王晶晶 马作军 韩盼盼 高莉娟 JIN Nan;DING Chun-mian;WANG Jing-jing;MA Zuo-jun;HAN Pan-pan;GAO Li-juan(Department of Anesthesia and Perioperative and Pain Medicine,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450003,China)

机构地区：[1]郑州大学第一附属医院麻醉与围手术期及疼痛医学部,郑州450003

出　　处：《医药论坛杂志》2024年第19期2044-2047,共4页Journal of Medical Forum

摘　　要：目的探讨老年前列腺癌腹腔镜根治术麻醉诱导插管后泵注右美托咪定对术后认知功能和氧化应激反应的影响。方法选取2022年9月—2023年8月郑州大学第一附属医院收治的86例择期行腹腔镜根治术的老年前列腺癌患者,随机分为观察组和对照组各43例。观察组麻醉诱导插管后泵注右美托咪定方式实施手术,对照组泵注生理盐水,以麻醉诱导前、术后1d及术后3d为观察节点,分别记为T_(0)、T_(1)、T_(2),采用蒙特利尔认知功能评分量表(MoCA)评估患者认知情况,并测定其各项血清学指标。以术前、手术开始2h、术后24h为观察节点,记为M_(0)、M_(1)、M_(2),测定并比较两组患者血清丙二醛及活性氧簇水平,观察患者氧化应激反应情况。结果两组MoCA评分在T_(0)、T_(2)节点比较,差异无统计学意义(P>0.05),观察组T_(1)节点MoCA评分(26.15±1.53)分,高于对照组(22.97±1.42)分,差异有统计学意义(P<0.05)。血清学指标层面,观察组患者T_(1)和T_(2)观察节点SOD分别为[(325.74±24.52)μ/mL、(285.45±25.98)μ/mL]及NSE水平分别为[(17.38±3.49)μg/L、(22.77±3.51)μg/L],均低于对照组,差异有统计学意义(P<0.05);两组M_(0)节点MDA及ROS水平比较,差异无统计学意义(P>0.05),观察组M_(1)和M_(2)节点MDA及ROS水平为(11.09±2.33)μmol/mL、(9.61±3.03)μmol/mL及(118.36±18.37)μmol/mL、(115.64±21.46)μmol/mL,均低于对照组,差异有统计学意义(P<0.05)。结论右美托咪定有助于缓解氧化应激反应,改善术后认知功能,改善预后,具有较高的临床应用价值。Objective To investigate the effects of dexmedetomidine pump injection on cognitive function and oxidative stress in elderly patients with prostate cancer after laparoscopic radical resection under anesthesia induction intubation.Methods Totally 86 cases of elderly patients aged 60-80 years old undergoing laparoscopic radical surgery in the First Affiliated Hospital of Zhengzhou from Septmber 2022 to August 2023 were selected as the study subjects,and divided into group control and group observation with 43 cases in each based on the method of randomized numerical table.Dexmedetomidine anesthesia was used to perform the surgery for the observation patients.Before the induction of anesthesia,1d postoperatively and 3 d postoperatively were taken as the observation nodes,which were recorded as T_(0),T_(1)and T_(2),respectively,and the patients'cognitive status was assessed by using the MoCA score,and their serological indexes were measured.Taking preoperative,2 h at the beginning of surgery,and 24 h postoperatively as observation nodes,noted as M_(0),M_(1),M_(2),the serum malondialdehyde and reactive oxygen cluster levels of the two groups of patients were measured and compared,and the patients'oxidative stress response was observed.Results At the level of cognitive function,the difference in cognitive levels of the two groups of patients in T_(0)and T_(2)based on MoCA assessment was not statistically significant(P>0.05);the group observation for T_(1)score[(26.15±1.53)points]was significantly higher than that of control group[(22.97±1.42)points],and the difference between groups was statistically significant(P<0.05).At the level of serological indexes,SOD levels at T_(1)and T_(2)nodes in the observation group were[(325.74±24.52)μ/mL,(285.45±25.98)μ/mL]and NSE levels were[(17.38±3.49)μg/l,(22.77±3.51)μg/l],respectively,which were lower than group control(P<0.05).There was no significant difference in MDA and ROS levels at M_(0)nodes between the two groups(P>0.05).The levels of MDA and ROS at M_(1)and M_(2)

关 键 词：腹腔镜根治术 右美托咪定 认知功能 氧化应激 

分 类 号：R737.25[医药卫生—肿瘤]