摘要
Abstract
Objective To compare different impacts of anesthesia on early cognitive function in elderly patients with lung cancer after surgery. Methods 60 cases of elective lung tumor patients ( ASA < Ⅲ ) , 60 to 79 years old, able to effectively communicate with physicians, and MMSE scores > 24 points were recruited. The patients were randomly divided into 2 groups (n = 30 each) : sevoflurane group ( group Ⅰ ) and isoflurane group ( group Ⅱ ) . For each group, on preoperative 1 d, leaving the anesthesia recovery room after surgery, 3 and 7 days after surgery. The Mini - mental State Examination ( MMSE) was used to score cognitive function. The postoperative determine cognitive dysfunction (POCD) was determined by use of Z - scoring method. For the two groups of patients,on the day before surgery and postoperative 1 h and 1 d, venous blood 5 ml was exampled to do enzyme - linked immunosorbent assay ( ELISA) for determining TNF - α and IL - 6 , in accordance with the instructions of the ELISA kit. Results Compared with preoperative 1 d (group Ⅰ : 28.2 ±2.2, group Ⅱ : 27. 9 ±1.7) , MMSE score decreased (group Ⅰ : 22. 7 ±3.0, group Ⅱ : 21.8 ±3.2, P <0. 05) in group Ⅰ and group Ⅱ when leaving the anesthesia recovery room 1 d after, and incidence of cognitive dysfunction increased (P <0.05). Compared with preoperative scores in group Ⅰ and group Ⅱ , leaving the PACU, MMSE score was lower ( Ⅰ : 25. 2 ± 2. 2, Ⅱ: 24. 9 ±1.9, P < 0. 05 ) in postoperative 1 d; and there was no significant difference between the two groups. Although there was a slight decrease in 3 days (Ⅰ:5, Ⅱ : 5 ) and 7 days (Ⅰ:0, Ⅱ : 1 ) after the operation, compared with the preoperative scores, the difference was not statistically significant ( P > 0. 05 ) . IL - 6 and TNF - α levels 1 h and 1 d after surgery were significantly higher than those 1 d before surgery , with statistically significant differences ( P < 0. 05 ) . Conclusions In elderly patients after receiving anesthesia and lung cancer surgery, when leaving recovery room, cognitive function declined at postoperative day 1 , and basically recovered three days to seven days after the operation. There was no difference in the anesthesia between the use of sevoflurane and isoflurane on cognitive dysfunction, which provides a variety of options for clinical senile anesthesia. Excessive lung tumors surgical stimulation and inflammatory cytokines may have impact on postoperative cognitive function.关键词
全身麻醉/认知功能障碍/老年人/七氟烷/异氟烷Key words
general anesthesia/ postoperative cognitive dysfunction/ elderly/ sevoflurane/ isoflurane分类
医药卫生
