Effect of glutamine on the early postoperative cognitive dysfunction of elderly patients undergoing surgery for colorectal can-cer
Objective To investigate the effect of glutamine on early postoperative cognitive function in elderly patients un-dergoing radical surgery for colorectal cancer.Methods Sixty-six patients undergoing radical colorectal cancer surgery were divid-ed into a glutamine group(group A)and a control group(group C),according to the random number table method,with 33 patients in each group.Both groups received the same anesthesia methods.While the group A was administered intravenous glutamine 0.5 g/kg 24 h before and 1 h after surgery,the group C received an equivalent amount of normal saline at same time points.The incidence of perioper-ative neurocognitive disorder(PND)within 7 d post-surgery was noted.Neuropsychological tests[Mini-Mental State Examination(MMSE),Digit Symbol Test,Forward Digit Span Test,Serial Addition Test,Trail Making Test,and Backward Digit Span Test]were con-ducted at 3 d preoperatively(T1),1 d postoperatively(T2),7 d postoperatively(T3).The differences between the results obtained 3 d preop-eratively and T3 were calculated.Serum concentrations of neuron-specific enolase(NSE),interleukin(IL-6),and S100 calcium-binding protein β(S 100β)were measured by enzyme-linked immunosorbent assay before anesthesia induction(T0),at T1,T2,and T3.Results The group C has a higher incidence of PND within 7 d post-surgery than group A(P＜0.05).In group C,the scores of the Trail Making Test at T2 and T3 were lower than those at 3 d preoperatively(all P＜0.05),and the results of the Digit Symbol Test and Serial Addition Test at T3 were lower than those at 3 d preoperatively(all P＜0.05).The differences among the 3 d preoperative and T3 scores for the Digit Symbol Test,Serial Addition Test,and Trail Making Test in group A were smaller than those in group C(all P＜0.05).Serum concentra-tions of NSE and S100β in group C were high at T1 and T2 compared to the concentration at T0(all P＜0.05).In group A,serum concen-trations of IL-6,NSE,and S1 00β at T,and T2,and NSE at T3,were lower than those in group C(all P＜0.05).There was no significant difference in other indexes between the two groups(all P＞0.05).Conclusions Glutamine can effectively reduce the incidence of ear-ly PND in patients undergoing radical colorectal cancer surgery.However,its long-term effects on cognitive function require further ob-servation.
NETL
NSTL
万方数据
