山东医药2013，Vol.53Issue(7)：15-18,4.DOI:10.3969/j.issn.1002-266X.2013.07.006
不同剂量右美托咪定麻醉对食管癌根治术患者术后认知功能的影响
Effect of anaesthesia by different doses of dexmedetomidine on the post-operative cognitive function in patients undergoing esophageal carcinoma radical operation
摘要
Abstract
Objective To observe the effect of anaesthesia by different doses of dexmedetomidine on the post-operative cognitive function in patients undergoing esophageal carcinoma radical operation. Methods Sixty patients undergoing e-sophageal carcinoma radical operation were randomly divided into three groups ( n = 20 ) , group C ( control group) , group Dl ( dexmedetomidine 0. 5 μg/kg) and group D2( dexmedetomidine 1 μg/kg). When the operation starts, dexmedetomidine 0.5 μg/kg and 1 μg/kg were infused within 10 minutes in group Dl and D2, while normal saline 20 mL in group C. Dexmedetomidine were then infused at rate of 0. 3 μg/( kg · h) and 0. 5 μg/( kg · h) until the end of operation. Venous blood samples were obtained at the time points below for the determination of superoxide dismutase( SOD) , malonyldialde-hyde(MDA) , IL-6 and neuron specific enolase (NSE) : the time before anaesthesia (Tl) , the end of operation ( T2 ) , the first day after operation( T3) and the seventh day after operation( T4). MMSE of all the patients were evaluated for the cognitive function. Results ① Compared with Tl, the activity of SOD were decreased in the three groups at the time of T2 and T3 , while higher in group D2 than the other two groups at the time of T3 (all P < 0.05) ; The concentration of the MDA were increased in the three groups at the time of T2 and T3, while lower in group D2 than the other two groupsat the time of T3( all P <0. 05). ② Compared with Tl , the level of IL-6 was decreased in the three groups at the other time, while higher in group D2 than the other two groups at the time of T2 and T3 ( all P < 0. 05 ) ; The concentration of NSE was decreased in the three groups at the at the time of T2 and T3, while higher in group D2 than the other two groups at the time of T2 and T3( all P <0. 05). ③Compared with 24 hours before operation, the scores of MMSE were decreased in the three groups at the first day after operation, MMSE scores in group D2 were higher than the other two groups at 1 day and 3 days after operation(all P<0. 05) ; There were 8, 4 and 10 cases of POCD complicated in group Dl , D2 and C, the incidence of group D2 was significantly lower than that of the group Dl and C. Conclusion Dexmedetomidine of 1 μg/kg could improve the cognitive function in patients undergoing esophageal carcinoma radical operation, the mechanism maybe lies in the effects of dexmedetomidine on the alleviation of oxidative stress injury and inflammation.关键词
右美托咪定/食管癌手术/认知功能障碍Key words
dexmedetomidine/ esophageal neoplasms/ cognitive disorders分类
医药卫生引用本文复制引用
张伟,张加强,孟凡民..不同剂量右美托咪定麻醉对食管癌根治术患者术后认知功能的影响[J].山东医药,2013,53(7):15-18,4.基金项目
河南省科技厅立项课题资助项目(122300410068). （122300410068）
