右美托咪定对老年右半结肠癌全麻手术患者术后缺氧性认知损伤及血清BDNF、CXCL8的影响  

Effect of Dexmedetomidine on Postoperative Hypoxic Cognitive Impairment and Serum Levels of BDNF and CXCL8 in Elderly Patients Undergoing General Anesthesia Surgery for Right-Sided Cancer

作　　者：温泉 张军[1] 叶园园 WEN Quan;ZHANG Jun;YE Yuanyuan(Department of Intoxication,Nanyang Central Hospital,Nanyang 473005,China)

机构地区：[1]南阳市中心医院麻醉科,河南南阳473005

出　　处：《河南医学研究》2025年第6期1060-1064,共5页Henan Medical Research

摘　　要：目的分析右美托咪定应用于老年右半结肠癌全麻手术患者的效果,观察其对术后缺氧性认知损伤及血清脑源性神经生长因子(BDNF)、CXC趋化因子配体8(CXCL8)的影响。方法回顾性选取2021年6月至2022年11月于南阳市中心医院接受手术治疗的90例老年右半结肠癌患者,根据麻醉方法分为观察组(45例)和对照组(45例)。其中对照组常规全麻处理,观察组给予常规全麻和右美托咪定,比较两组不同时刻[t_(0)(给药前)、t_(1)(气管插管时)、t_(2)(手术开始30 min)、t_(3)(手术缝合时)]平均动脉压(MAP)、心率、术后恢复情况(术后睁眼时间、拔管时间及躁动评分)及不同时刻(术前1 d、术后1 d、术后3 d)认知功能。结果观察组t_(0)、t_(1)、t_(2)、t_(3)时刻心率均低于对照组(P<0.05),各时刻MAP两组对比,差异无统计学意义(P>0.05);观察组睁眼、拔管时间均短于对照组,躁动评分低于对照组(P<0.05);术后1、3 d观察组缺氧性认知损伤简明精神状态检查表(MMSE)评分高于对照组(P<0.05);术后1、3 d观察组血清BDNF水平高于对照组,血清CXCL8水平低于对照组(P<0.05);两组术后不良反应发生率比较,差异无统计学意义(P>0.05)。结论右美托咪定麻醉应用于老年右半结肠癌全麻手术患者,能缓解术后躁动,减轻炎症反应,保护认知功能,缩短术后拔管时间,促进患者术后恢复。Objective To analyze the efficacy of dexmedetomidine in elderly patients undergoing general anesthesia surgery for right-sided rectal cancer,and to observe its effects on postoperative hypoxic cognitive impairment and serum levels of brain derived nerve growth factor(BDNF)and C-X-C motif chemokine ligand 8(CXCL8).Methods A total of 90 elderly patients with right-sided rectal cancer who underwent surgical treatment at Nanyang Central Hospital from June 2021 to November 2022 were retrospectively selected,and divided were into an observation group(45 cases)and a control group(45 cases)based on the anesthesia method.Among them,control group was treated with conventional general anaesthesia,and observation group was given conventional general anaesthesia and dexmedetomidine.The mean arterial pressure(MAP),heart rate,postoperative recovery(postoperative eye-opening time,extubation time,and agitation scores)of the two groups at different moments[t_(0)(before the administration of the drug),t_(1)(at the time of endotracheal intubation),t_(2)(at the time of starting the surgery for 30 min),t_(3)(at the time of surgical closure)],as well as at different moments(preoperative 1 day,postoperative 1 day,and postoperative 3 days)cognitive function were compared.Results Heart rate of observation group at t_(0),t_(1),t_(2) and t_(3) were lower than that of control group(P<0.05),and there was no significant difference between the two groups in the comparison of MAP at all moments(P>0.05).Observation group’s eye-opening and extubation times were shorter than that of control group,and the agitation score was lower than that of control group(P<0.05).The mini-mental state examination(MMSE)score of hypoxic cognitive impairment in observation group was higher than that in control group on the preoperative 1 and 3 days(P<0.05).On the preoperative 1 and 3 days,the serum BDNF levels in observation group were higher than those in control group,while the serum CXCL8 levels were lower than those in control group(P<0.05).There was no signifi

关 键 词：右半结肠癌 右美托咪定 认知功能 拔管时间 

分 类 号：R614[医药卫生—麻醉学]