针刺复合全麻对老年肿瘤切除术患者术后认知功能及相关炎症因子的影响

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摘要目的探讨针刺复合全麻对老年肿瘤切除术患者术后认知功能及相关炎症因子的影响。方法选取2015年 6月~2016年12月湖南中医药大学第一附属医院收治的98例老年肿瘤切除术患者为研究对象，采用随机数字表法分为两组，各49例。对照组行单纯全麻，观察组行针刺复合全麻。术前1 d、术后1 d及术后3 d采用简易智力状态测试量表（MMSE）对所有患者进行评估，计算术后认知功能障碍（POCD）的发生率。术前、术毕、术后24 h和术后48 h采用酶联免疫吸附法（ELISA）测定患者血清肿瘤坏死因子（TNF-α）、白细胞介素-1β（IL-1β）、白细胞介素-6（IL-6）水平。结果术后1 d和术后3 d观察组MMSE评分高于对照组，POCD发生率低于对照组，差异有统计学意义（P ＜ 0.05）。与术前比较，术毕、术后24 h及术后48 h两组TNF-α、IL-1β及IL-6水平升高，而观察组的升高幅度均低于对照组，差异有统计学意义（P ＜ 0.05）。结论针刺复合全麻可以降低老年肿瘤切除术患者POCD发生率，其作用机制可能与降低患者体内TNF-α、IL-1β及IL-6水平有关。

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	刘智滕永杰

关键词 ：针刺复合全麻, 术后认知功能障碍, 炎症因子

Abstract：Objective To investigate the effect of acupuncture combined with general anesthesia on cognitive function and related inflammatory factors in elderly patients underwent tumor resection. Methods A total of 98 elderly patients underwent tumor resection in the First Affiliated Hospital of Hu′nan University of Traditional Chinese Medicine from June 2015 to December 2016 were enrolled. The patients were divided into two groups according to the random number table method, each group had 49 cases. Patients in the control group were treated with general anesthesia. Patients in the observation group were treated with acupuncture combined with general anesthesia. All patients were scored by mini-mental state examination (MMSE) at 1 day before operation, 1 day after operation and 3 days after operation. The incidence of postoperative cognitive dysfunction (POCD) was calculated. The levels of serum TNF-α, IL-1β and IL-6 were measured by enzyme-linked immunosorbent assay (ELISA) before operation, at operation completed, 24 h and 48 h after operation. Results The MMSE scores of the observation group were significantly higher than those of the control group at 1 day and 3 days after operation, the incidence rates of POCD were lower than those of the control group, the differences were statistically significant (P < 0.05). The levels of TNF-α, IL-1β and IL-6 in the two groups at operation completed, 24 h and 48 h after operation were significantly higher than those before operation, and the observation group were lower than those of the control group, the differences were statistically significant (P < 0.05). Conclusion Acupuncture combined with general anesthesia can reduce the incidence of POCD in elderly patients underwent tumor resection. The mechanism may be related to the decrease of the levels of serum TNF-α, IL-1β and IL-6 in patients.

Key words： Acupuncture combined with general anesthesia Postoperative cognitive dysfunction Inflammatory factors

基金资助:湖南省科技厅科研资助项目（2016FJ6021）。

通讯作者: 滕永杰（1975.7-），硕士，副主任医师；研究方向：心血管手术的临床麻醉。

作者简介: 刘智（1982.9-），男，硕士；研究方向：针刺复合全身麻醉的临床应用。

引用本文:

刘智滕永杰. 针刺复合全麻对老年肿瘤切除术患者术后认知功能及相关炎症因子的影响[J]. 中国医药导报, 2017, 14(22): 76-79.
LIU Zhi TENG Yongjie. Effect of acupuncture combined with general anesthesia on cognitive function and related inflammatory factors in elderly patients with tumor resection. 中国医药导报, 2017, 14(22): 76-79.

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http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2017/V14/I22/76

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