摘要
目的:探究艾司氯胺酮复合丙泊酚麻醉对老年乳腺癌根治术患者应激水平、认知功能及血清BDNF、NSE水平的影响.方法:选取2020 年5 月至2022 年7 月于本院进行乳腺癌根治术90 例老年患者,根据随机数字表法将其进一步分为观察组(45 例,艾司氯胺酮联合丙泊酚)和对照组(45 例,丙泊酚麻醉).比较两组患者应激水平、认知功能及血清 BDNF、NSE 水平.结果:观察组 T2、T3、T4 时间点皮质醇、肾上腺素水平相较于T0 时间点均明显升高(P<0.05);对照组T1、T2、T3、T4 时间点皮质醇、肾上腺素水平相较于 T0 时间点均明显升高(P<0.05);观察组 T1、T2、T3、T4 时间点皮质醇、肾上腺素水平升高幅度相较于对照组均明显降低(P<0.05);两组术后 24h、48h 认知功能评分及 BDNF 水平下降,NSE水平上升,且观察组变化优于对照组(P<0.05);观察组苏醒、拔管及定向力恢复时间相较于对照组均明显缩短(P<0.05).结论:艾司氯胺酮复合丙泊酚麻醉老年乳腺癌根治术患者可减轻机体应激反应、加快认知功能恢复、改善术后苏醒质量.
Abstract
Objective:To investigate the effects of es-ketamine combined with propofol anesthesia on stress levels,cognitive function,and serum BDNF and NSE levels in elderly patients undergoing radical mas-tectomy for breast cancer.Methods:Ninety elderly patients who underwent radical mastectomy for breast cancer at our hospital from May 2020 to July 2022 were selected and further divided into the observation group(45 cases,es-ketamine combined with propofol)and the control group(45 cases,propofol anesthesia)ac-cording to a random number table method.The stress levels,cognitive function,and serum BDNF and NSE levels of the two groups were compared.Results:In the observation group,cortisol and adrenaline levels at T2,T3,and T4 time points were significantly higher compared to T0 time point(P<0.05).In the control group,cortisol and adrenaline levels at T1,T2,T3,and T4 time points were significantly higher compared to T0 time point(P<0.05).The increase in cortisol and adrenaline levels at T1,T2,T3,and T4 time points in the observation group was significantly lower than that in the control group(P<0.05).Both groups showed a decrease in cognitive function scores and BDNF levels and an increase in NSE levels at 24h and 48h postoper-atively,with the observation group showing better changes than the control group(P<0.05).The awakening,extubation,and orientation recovery times in the observation group were significantly shorter than those in the control group(P<0.05).Conclusion:Es-ketamine combined with propofol anesthesia in elderly patients un-dergoing radical mastectomy for breast cancer can reduce the body's stress response,accelerate cognitive func-tion recovery,and improve the quality of postoperative awakening.
基金项目
湖北省卫生健康委员会科研项目(WJ2019H256)
国家科技期刊平台
NSTL
万方数据