Yuan Jun, Wu Yu, Li Ji-yong, Chen Xi, Zhang Li, Liu Yu-feng, Tong Sheng-xiong, Deng Fang-fang
Zhongguo Zhong Xi Yi Jie He Za Zhi. 2016 Mar;36(3):285-8.
To explore the effect of dexmedetomidine combined electrical stimulation on cognitive function of neurosurgical diseases patients treated by extracerebral intervention.
Totally 122 patients with neurosurgical diseases who underwent selective intervention were randomly assigned to the observation group and the control group, 61 cases in each group. Patients in the control group recieved anesthesia by dexmedetomidine. Those in the observation group received electrical stimulation at Baihui (DU20), Yintang ( EX-HN3), and Neiguan (PC6) before dexmedetomidine anesthesia. The cognitive function of patients at preoperative day 1 and postoperative day 1 was respectively evaluated by Mini-Mental State Examinations (MMSE). Serum NSE, S-100β, IL-1β, IL-6, and TNF-α levels were detected in the two groups before intervention and immediately after intervention using ELISA.
MMSE scores of two groups were significantly reduced at post-intervention day 1, as compared with one day before intervention. MMSE score of the observation group at post-intervention day 1 was (23.15 ± 1.87) points, significantly higher than that of the control group [ (19.34 ± 1.64) points , (P < 0.05)]. The postoperative cognitive dysfunction (POCD) incidence rate of the observation group was 16.4% (10/61), significantly lower than that of the control group [39.3% (24/61); P < 0.05]. Compared with before intervention, NSE and S-100β protein levels, IL-1β, IL-6 and α-TNF levels of the two groups increased (P < 0.05). Post-intervention NSE and S-100β protein levels, IL-1β, IL-6 and α-TNF levels were significantly lower in the observation group than in the control group (P < 0.05).
Dexmedetomidine combied electrical stimulation could effectively prevent the occurrence of postoperative cognition, and reduce levels of NSA, S-100β, IL-1β, IL-6 and TNF-α.
探讨右美托咪定联合电刺激对接受脑外干预治疗的神经外科疾病患者认知功能的影响。
将122例接受选择性干预的神经外科疾病患者随机分为观察组和对照组,每组61例。对照组患者接受右美托咪定麻醉。观察组患者在右美托咪定麻醉前于百会(DU20)、印堂(EX-HN3)和内关(PC6)进行电刺激。分别在术前1天和术后1天采用简易精神状态检查表(MMSE)评估患者的认知功能。采用酶联免疫吸附测定法(ELISA)在干预前和干预后即刻检测两组患者血清神经元特异性烯醇化酶(NSE)、S-100β蛋白、白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)水平。
与干预前1天相比,两组患者干预后1天的MMSE评分均显著降低。观察组干预后1天的MMSE评分为(23.15±1.87)分,显著高于对照组[(19.34±1.64)分,(P<0.05)]。观察组术后认知功能障碍(POCD)发生率为16.4%(10/61),显著低于对照组[39.3%(24/61);P<0.05]。与干预前相比,两组患者的NSE和S-100β蛋白水平、IL-1β、IL-6和TNF-α水平均升高(P<0.05)。干预后,观察组的NSE和S-100β蛋白水平、IL-1β、IL-6和TNF-α水平显著低于对照组(P<0.05)。
右美托咪定联合电刺激可有效预防术后认知功能障碍的发生,并降低NSE、S-100β、IL-1β、IL-6和TNF-α水平。