肺保护性通气对老年全麻腹部手术患者术后认知及氧化损伤的影响OA
Influence of Lung Protective Ventilation on Postoperative Cognitive and Oxidative Damage of Elderly Patients with General Anesthesia for Abdominal Surgery
目的:探究肺保护性通气对老年全麻腹部手术患者术后认知及氧化损伤的影响.方法:将2022 年 1 月—2023 年 12 月江苏省苏北人民医院的 80 例老年全麻腹部手术患者根据随机数字表法分为两组,每组 40 例.对照组进行常规通气,观察组则进行肺保护性通气.比较两组术后的认知障碍发生率、肺部并发症发生率、手术前后的氧合功能状态[动脉血氧分压(PaO2)及氧合指数(OI)]、认知功能相关指标[血清经元特异性烯醇化酶(NSE)、S100 钙结合蛋白B(S100B)及神经生长因子(NGF)]及氧化损伤指标[血清总抗氧化能力(TAC)、丙二醛(MDA)、超氧化物歧化酶(SOD)及活性氧(ROS)].结果:观察组的术后认知障碍发生率及肺部并发症发生率均显著低于对照组,差异均有统计学意义(P<0.05).术前,两组的氧合功能状态、认知功能相关指标及氧化损伤指标比较,差异均无统计学意义(P>0.05);术后 1、3 d观察组的氧合功能状态及TAC、SOD均显著高于对照组,认知功能相关指标及MDA、ROS均显著低于对照组,差异均有统计学意义(P<0.05).结论:肺保护性通气可有效控制老年全麻腹部手术患者的术后认知障碍及肺部并发症发生率,且对于氧化损伤的控制效果较好.
Objective:To investigate the influence of protective ventilation on postoperative cognitive and oxidative damage of elderly patients with general anesthesia for abdominal surgery.Method:A total of 80 elderly patients with general anesthesia for abdominal surgery in Northern Jiangsu People's Hospital from January 2022 to December 2023 were divided into two groups by random number table method,with 40 cases in each group.The control group was treated with routine ventilation,the observation group was treated with lung protective ventilation.The incidence of postoperative cognitive impairment and pulmonary complications,oxygenation function state[arterial partial pressure of oxygen(PaO2)and oxygenation index(OI)],cognitive function related indexes[serum neuron-specific enolase(NSE),S100 calcium binding protein B(S100B)and nerve growth factor(NGF)]and oxidative damage indexes[serum total antioxidant capacity(TAC),malondialdehyde(MDA),superoxide dismutase(SOD)and reactive oxygen species(ROS)]before and after the operation of two groups were compared.Result:The incidences of postoperative cognitive impairment and pulmonary complications of observation group were significantly lower than those of control group,the differences were statistically significant(P<0.05).Before the operation,the oxygenation function state,cognitive function related indexes and oxidative damage indexes of two groups were compared,the differences were not statistically significant(P>0.05);at first and third day after the operation,the oxygenation function state and TAC,SOD of observation group were significantly higher than those of control group,the cognitive function related indexes and MDA,ROS were significantly lower than those of control group,the differences were statistically significant(P<0.05).Conclusion:The lung protective ventilation can effectively control the incidence of postoperative cognitive impairment and pulmonary rates in elderly patients with general anesthesia for abdominal surgery,and its control effect for oxidative damage of elderly patients is better.
周群;刘珊;林舜艳;孙鹏飞
江苏省苏北人民医院麻醉科 江苏 扬州 225001江苏省苏北人民医院医学检验科 江苏 扬州 225001
肺保护性通气老年患者全麻腹部手术认知状态氧化损伤
Lung protective ventilationElderly patientsGeneral anesthesiaAbdominal surgeryPostoperative cognitiveOxidative damage
《中国医学创新》 2024 (024)
23-27 / 5
江苏省苏北人民医院院级科研基金项目青年托举专项(SBQN22018);江苏省扬州市科技计划重点研发项目(社会发展)专项(YZ2023097)
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