中国医科大学学报

中国医科大学学报

中国医科大学学报 ›› 2016, Vol. 45 ›› Issue (3): 233–236.doi: 10.12007/j.issn.0258-4646.2016.03.011

• 论著 • 上一篇    下一篇

甲强龙联合经皮穴位电刺激对老年患者术后认知功能的影响

朱俊超,杨延超,滕秀飞,金宁,白文娅,刘诗煜,史胜哲   

  1. 中国医科大学附属盛京医院麻醉科,沈阳 110004
  • 收稿日期:2015-12-01 出版日期:2016-02-29 发布日期:2016-02-24
  • 作者简介:朱俊超(1974 -),女,副教授,博士.
  • 基金资助:
    中国医科大学附属盛京医院三新项目(2015PS57J)

Effects of Methylprednisolone Combined with Transcutaneous Acupiont Electric Stimulation on Postoperative Cognitive Dysfunction in Elderly Patients

ZHU Jun-chao,YANG Yan-chao,TENG Xiu-fei,JIN Ning,BAI Wen-ya,LIU Shi-yu,SHI Sheng-zhe   

  1. Department of Anesthesiology,Shengjing Hospital,China Medical University,Shenyang 110004,China
  • Received:2015-12-01 Online:2016-02-29 Published:2016-02-24

摘要: 目的 研究甲强龙联合经皮穴位电刺激对老年患者术后认知功能的影响。方法 选择行下腹部手术的老年患者 60例,随机分为经皮穴位电刺激组(T 组)和甲强龙联合经皮穴位电刺激组(M 组)。T 组给予电刺激,M 组给予甲强龙联合电刺激。于术前 1 d 及术后第 1、2、3、7 天,用 MOCA 量表评估患者的术后认知功能;测定患者在诱导前(T0)、术毕(T1)、术后 24 h(T2)、48 h(T3)血清 Aβ1-42、p-Tau 浓度;计算患者术中脑氧饱和度(rSO2)平均值及较基础值下降的最大百分数(rSO2%max)。结果 M 组术后第 2 天 MOCA 评分较 T 组升高,且术后认知功能障碍发生率低于 T 组(13.3% vs 23.3%);M 组在 T2、T3 时的 Aβ1-42及 p-Tau 浓度较 T 组低(P < 0.05)。2 组 rSO2 基础值、围术期 rSO2 平均值以及 rSO2%max 比较,差异无统计学意义(P > 0.05)。结论 甲强龙联合经皮穴位电刺激可降低老年患者术后认知功能障碍的发生率。

关键词: 甲强龙, 经皮穴位电刺激, 脑氧饱和度, 术后认知功能障碍

Abstract: Objective To evaluate the effects of methylprednisolone combined with transcutaneous acupiont electric stimulation on postoperative cognitive dysfunction(POCD)in elderly patients. Methods Sixty elderly patients scheduled for hypogastrium surgery were recruited for the study and randomly divided into two groups:transcutaneous acupiont electric stimulation group(T group)and methylprednisolone combined with transcutaneous acupiont electric stimulation group(M group). The patients in T group received electric stimulation,and those in M group were administrated with intravenous methylprednisolone and electric stimulation. The incidence of POCD was evaluated with Montreal Cognitive Assessment(MO-CA)at the time points of one day before the surgery,one day,two days,three days,and seven days after the surgery,respectively;the serum Aβ1-42 and p- Tau concentration was determined at the time points of the time before the induction(T0),the end of the surgery(T1),24 h,and 48 h af- ter the surgery(T2,T3);the average rSO2 and the maximum reduced percentage compared with the basic value(rSO2%max)during the operation were calculated. Results The MOCA score at two days after surgery was higher and the incidence of POCD was lower in M group than those in T group(13.3% vs 23.3%). The concentration of the serum Aβ1-42 and p-Tau in M group was lower than that in T group at T2,T3(P < 0.05),there wereno statistical significances of the baseline rSO2,average rSO2 and the rSO2%max(P > 0.05). Conclusion Methylprednisolone combined with transcutaneous acupiont electric stimulation could decrease the incidence of POCD in elederly patients under general anesthesia.

Key words: methylprednisolone, transcutaneous acupiont electric stimulation cerebral oxygen saturation, postoperative cognitive dysfunction

中图分类号: 

  • R614.2
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