| 饶 青 丛海涛.右美托咪定对腹腔镜手术患者血清炎症因子及术后认知功能的影响[J].中国现代医生,2021,59(8):111-114 |
| 右美托咪定对腹腔镜手术患者血清炎症因子及术后认知功能的影响 |
| Effects of dexmedetomidine on serum inflammatory factors and postoperative cognitive function in patients undergoing laparoscopic surgery |
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| DOI： |
| 中文关键词: 腹腔镜手术 右美托咪定 炎症因子 术后认知功能 |
| 英文关键词:Laparoscopic surgery Dexmedetomidine Inflammatory factors Postoperative cognitive function |
| 基金项目:浙江省医药卫生科技计划项目（2018KY885） |
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| 中文摘要: |
| 目的 探讨右美托咪定对腹腔镜手术患者血清炎症因子及术后认知功能的影响。方法 选取2016年1月到2019年6月在我院行腹腔镜手术患者84例，随机分为观察组和对照组，每组各42例。观察组麻醉诱导前予静脉泵注负荷剂量右美托咪定0.5 μg/kg，并以0.1 μg/（kg·h）速度持续泵注至术前30 min；对照组予等剂量生理盐水替代。观察两组术前（T1）、手术结束时（T2）、术后24 h（T3）及术后48 h（T4）血清白介素（IL）-6和肿瘤坏死因子（TNF）-α 水平的变化，并比较T1、T3和T4时认知功能的变化。结果 两组T2、T3和T4时血清IL-6和TNF-α 水平均较T1时显著上升（P＜0.05或P＜0.01），且对照组上升值较观察组更显著（P＜0.05）；同时两组T2、T3和T4时TMT完成时间较T1明显上升，MMSE评分较T1显著下降（P＜0.05或P＜0.01），且对照组变化值较观察组更明显（P＜0.05）。结论 右美托咪定用于腹腔镜手术患者可改善术后认知功能，减轻手术及麻醉对其认知功能的影响，其作用机制可能是抑制炎症因子IL-6和TNF-α 的分泌，减轻炎症因子对神经功能的损伤 |
| 英文摘要: |
| Objective To investigate the effect of dexmedetomidine on serum inflammatory factors and postoperative cognitive function in patients undergoing laparoscopic surgery.Methods Eighty-four patients who underwent laparoscopic surgery in our hospital from January 2016 to June 2019 were seleted and randomly divided into observation group and control group,with 42 patients in each group.In the observation group,the loading dose of dexmedetomidine was injected intravenously before anesthesia induction at 0.5 μg/kg,and was continuously pumped until 30 min before surgery at the rate of 0.1 μg/(kg·h).The control group was given equal dose normal saline instead.The changes in serum levels of interleukin (IL)-6 and tumor necrosis factor (TNF)-α were observed before (T1),at the end of operation(T2),24 hours after operation(T3) and 48 hours after operation(T4),and the changes in cognitive function at T1,T3and T4were compared.Results The levels of serum IL-6 and TNF-α in the two groups at T2,T3and T4were significantly higher than those at T1(P＜0.05 or P＜0.01),and the levels of IL-6 and TNF-α in the control group were significantly higher than those in the observation group(P＜0.05).At the same time,at T2,T3and T4,the completion time of TMT was significantly increased compared with T1,and MMSE score was significantly decreased compared with T1(P＜0.05 or P＜0.01),and the change value in the control group was more significant than that in the observation group(P＜0.05).Conclusion Dexmedetomidine can improve postoperative cognitive function of patients undergoing laparoscopic surgery,and reduce the influence of surgery and anesthesia on cognitive function of patients.The mechanism of action may be to reduce the damage of inflammatory factors on nerve function by inhibiting the secretion of inflammatory cytokines IL-6 and TNF-α. |
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