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目的观察腹腔镜下直肠癌根治术对患者的早期认知功能障碍的影响和右美托咪定的干预作用。方法随机将80例在本院外科住院,ASAⅠ~Ⅱ拟行腹腔镜下根治术的直肠癌患者分为右美托咪定组(D组)和生理盐水对照组(C组),在手术前和手术后分别给予持续性泵注右美托咪定和生理盐水,并于术后观察两组患者的早期认知功能变化。结果与手术前相比,D组患者的简易智力状态检查法(MMSE)测试评分无明显改变(P>0.05),而C组患者的MMSE测试评分显著降低(P<0.05),手术后第1天和第3天D组患者的MMSE测试评分显著优于C组(P<0.05),两组患者术后早期认知功能障碍的发生率分别为22.5%和55.0%,C组患者的术后早期认知功能障碍明显高于D组且障碍程度较重(P<0.05)。结论右美托咪定有利于缓解直肠癌患者在进行腹腔镜下直肠癌根治术后的早期认知功能障碍,在临床上有一定的推广价值。
Objective To observe the effect of laparoscopic radical resection of rectal cancer on early cognitive dysfunction in patients and the effect of dexmedetomidine. Methods A total of 80 patients with rectal cancer who underwent laparoscopic ASA Ⅰ ~ Ⅱ surgery in our hospital were randomly divided into two groups: dexmedetomidine group (D group) and saline control group (C group). Before operation And after surgery were given continuous infusion of dexmedetomidine and saline, and postoperative observation of two groups of patients with early cognitive changes. Results Compared with those before operation, the score of MMSE in group D was not significantly changed (P> 0.05), while the score of MMSE in group C was significantly lower (P <0.05) The scores of MMSE in group D on day and day 3 were significantly better than those in group C (P <0.05). The incidences of early cognitive impairment in both groups were 22.5% and 55.0% Early cognitive dysfunction was significantly higher in group D than in group D (P <0.05). Conclusion Dexmedetomidine helps to alleviate the early cognitive dysfunction in patients with rectal cancer after laparoscopic radical resection of rectal cancer, and has certain clinical value.