七氟烷静吸复合右美托咪定麻醉对老年腹腔镜肿瘤切除术后认知功能及血清NGF、BDNF水平的影响.docx

《七氟烷静吸复合右美托咪定麻醉对老年腹腔镜肿瘤切除术后认知功能及血清NGF、BDNF水平的影响.docx》由会员分享，可在线阅读，更多相关《七氟烷静吸复合右美托咪定麻醉对老年腹腔镜肿瘤切除术后认知功能及血清NGF、BDNF水平的影响.docx（9页珍藏版）》请在第一文库网上搜索。

1、七氟烷静吸复合右美托咪定麻醉对老年腹腔镜肿瘤切除术后认知功能及血清NGF、BDNF水平的影响黄代强袁静一孙静雪-易姝彤-赵雷深圳市人民医院(暨南大学第二临床医学院)麻醉科，广东深圳518020基金项目：深圳市科技创新委员会基础研究(项目编号：JCYJ200540)【摘要】目的：研究七氟烷静吸复合右美托咪定麻醉对老年腹腔镜肿瘤切除术后认知功能及 血清神经生长因子(NGF)、脑源性神经营养因子(BDNF)水平的影响，为临床研究提供 指导。方法：选取深圳市人民医院于2018年9月-2020年9月收治的80例行腹腔镜肿瘤切 除术的老年患者进行研究，按照随机数表法分为观察组和对照组各40例。对照组行七氟

2、烷 静吸麻醉，观察组行七氟烷静吸复合右美托咪定麻醉。观察并比较两组患置麻醉前IOmin(T0)、麻醉后IOmin (Ti)、手术中工)、手术后口)的心率和血氧饱和度，术中血 压水平、出血量，术后苏醒时间、说话时间以及拔管时间,麻醉前、术后Id、3d、5d的简 易智力状态检查量表(MMSE)评分和连线试验(TMT)完成时间情况，以及两组麻醉前、 术后血清BDNF、NGF水平变化情况。结果：两组患者的心率、血氧饱和度在Ti、TZ时均 较To时明显升高，对照组心率、血氧饱和度在Ti T2时分别为(10768457)次/min、(98.450.39)% (97.595.25)次/min、(98.010

3、.39)%,均明显高于观察组的(102.094.69) 次/min、(97.26+0.30) %、(92.18+3.92)次/min、(96.73+0.34) %,差异均具有统计学意 义(P0.05)；观察组患者术中收缩压、舒张压、术中出血量分别为(120.21+10.40) mmHg、(78.12+9.95) mmHg、(226.15+8.12) ml,明显低于对照组的(126.42+10.21) mmHg、 (83.269.11)mmHg (234.518.74)ml,苏醒时间、说话时间、拔管时间分另IJ为(40.522.52) min、(110.17+12.10) min、(90.47+

4、12.51) min,明显短于对照组的(46.772.13) min、(115.42+12.28) min、(99.56+12.12) min,差异均有统计学意义(P0.05)；术后 Id、3d, 两组患置弛TMT完成时间较麻醉前延长，对照组分别为(46.16+3.05) s、(44.84+2.64) s, 明显长于观察组的(44.32268) s、(43.38+2.78) s,差异均有统计学意义(PVO.05)；术 后ld、3d,两组患者的MMSE评分较麻醉前降低,对照组分别为(24.921.69)分、(25.461.56) 分，明显低于观察组的(25.91L37)分、(26.56L36)分

5、，差异均具有统计学意义(P0.05); 术后，观察组两组患者的血清BDNF、NGF水平分别为(23.625.48) pg/ml、(29.763.33) PHml,均明显低于麻醉前的(24.315.51) PHm1、(28.92L79) PHm1,对照组患者的血清 BDNF、NGF 水平分别为(24.315.51) pg/ml、(28.92L79) pgml,均明显低于麻醉前的(29.225.43) pRml、(32.601.94) PRm1,差异均有统计学意义(P0.05) o结论：七氟烷静吸复合右美托咪定麻醉应 用于老年腹腔镜肿瘤切除术对患者的血流动力学影响较小,且可降低血清中NGF. BD

6、NF含 量，促进患者术后认知功能恢复。【关键词】肿瘤切除手术；麻醉药物；七氟烷；右美托咪定；认知功能；神经生长因子；脑 源性神经营养因子Effect of Sevoflurane inhalation combined with dexmedetomidine anesthesia on cognitivefunction and serum NGF and BDNF levels after laparoscopic tumor resection in elderlypatientsHuang Daiqiang, Yuan Jing, sun Jingxue, Yi Shutong, Zh

7、ao LeiDepartment of Anesthesiology, Shenzhen Peoples Hospital (Second Clinical Medical College of Jinan University) 518020Abstract Objective: To study the effect of Sevoflurane inhalation combined with dexmedetomidine anesthesia on cognitive function and serum Serum nerve growth factor (NGF), brain-

8、derived neurotrophic factor (BDNF) levels after laparoscopic tumor resection in elderly patients, provide guidance for clinical research. Methods: 80 elderly patients undergoing laparoscopic tumor resection from September 2018 to September 2020 in DePartment Of AneStheSiOIOgy Of ShenZhen Peoples HoS

9、Pital were selected for research , and they were divided into observation group and control group according to the random IlUmber table method, With 40 cases in each group. The control group was anesthetized with sevoflurane, and the observation group was anesthetized with Sevoflurane combined with

10、dexmedetomidine. The heart rate and blood OXygen SatUratiOn Of the two groups Of PatientS Iomin before anesthesia (T，Iomill after anesthesia (Ti), during the OPeration (T2), and after the OPeratiOn (T3), intraoperative blood PreSSUre level, blood IOSs, POStOPeratiVe recovery time, SPeeCh time and ex

11、tubation time, MMSE SCOre and COImeCtion test (TMT) COmPIetiOn time before anesthesia and Id, 3d, 5d after anesthesia, and ChangeS in SerUm BDNF and NGF IeVeIS before and after anesthesia Were ObSerVed and ts: The heart rate and blood oxygen saturation of the two groups were significantly higher at

12、Tl and T2 than at To, the heart rate and blood oxygen saturation of the control group were (107.68+4.57) beats/min and (98.45+0.39)%, (97.59+5.25) times/min, (98.01+0.39)%,which were significantly higher than the observation group (102.09+4.69) times/min, (97.26+0.30)%, (92.18+3.92) times/min, (96.7

13、3+0.34)%, the difference was statistically significant (PVO.05)Rhe intraoperative SyStoIiC blood PreSSUre, diastolic blood PreSSUre, and intraoperative blood loss in the observation group were (120.21+10.40) mmHg, (78.12+9.95) mmHg, and (226.15+8.12) ml, which were significantly lower than those of

14、the control group (126.42+10.21) mmHg, (83.26+9.11) mmHg, and (234.5l+8.74)ml,the wake-up time, speaking time, and extubation time were (40.52+2.52)min, (110.17+12.10)min, (90.47+12.5l)min, which were significantly shorter than the control group (46.77+2.13) min, (115.42+12.28) min, (99.56+12.12) mi

15、n, the difference was statistically significant (P0,05); Aat 1 and 3 days after operation, the completion time of TMT in the two groupsWaSere longer than that before anesthesia, the control group were (46.16+3.05) s and (44.84+2.64) s, which were significantly longer than the observation groups (44.

16、32+2.68) s and (43.38+2.78)si the differences Were StatiStiCaIIy SignifiCant (PVo.05)：; at 1 and 3 days after operation, the MMSE SCOreS Of the two groups Were IOWer than those before anesthesia, the SCOreS in the ContrOl group Were (24.921.69) and (25.461.56), WhiCh Were SignifiCantIy IOWer than those in the ObSerVatiOn group (25.911.37) and (26.56). 1.36) points, the differences We