术前新辅助化疗对老年直肠癌患者术后神经认知功能恢复延迟的影响OACSTPCD

Objective To investigate the effect of preoperative neoadjuvant chemotherapy on delayed neurocognitive recovery(DNR)in elderly patients with rectal cancer.Methods A total of 173 patients over 65 years old who were admitted to Tianjin People's Hospital from July 2021 to June 2023 for rectal cancer undergoing elective surgery under general anesthesia were selected and divided into preoperative NACT group(group C)and preoperative non-NACT group(group N)according to whether they received neoadjuvant chemotherapy(NACT)before surgery.A series of neuropsychological tests were used to evaluate the cognitive function of the patients 1 day before operation and 30 days after operation.The occurrence of DNR in patients was observed,and the independent risk factors of DNR after surgery were analyzed by multivariatebinary logistic regression.Results Both groups completed all relevant neuropsycho-logical tests.Compared with group N,the MMSE score and MoCA score of group C were lower 1 and 3 days after surgery,and the VAS score of group C was higher(P<0.05).The incidence of DNR in group C(55.3%)was significantly higher than that in group N(31.8%)(P<0.05).On the 30th day after surgery,compared with the neuropsychological test in group N,the score of the TICS-M assessment in the C group was lower(P<0.05),but there was no significant difference in the incidence of DNR of the two groups.Conclusions Preoperative neoadjuvant chemotherapy can increase the incidence of DNR and sensitiveness to pain in elderly patients with rectal cancer.