You Zhijian, Chen Lesi, Xu Hongxia, Huang Yidan, Wu Jinglei, Wu Jiaxuan
Department of Anesthesiology, Liuzhou People's Hospital, Liuzhou, China.
Department of Anesthesiology, The Second Affiliated Hospital of Shantou University Medical College, Shantou, China.
Front Mol Biosci. 2021 Nov 26;8:786070. doi: 10.3389/fmolb.2021.786070. eCollection 2021.
Cognitive dysfunction is a common disease in aging population. This study aims to compare the influence of different degrees of anemia on the cognitive function of patients undergo hysteromyoma surgery. Sixty-one patients aged 18-60 years who underwent uterine fibroid surgery in the Second Affiliated Hospital of Shantou University Medical College from March 2019 to December 2020 were selected for this study. Patients were divided into three groups: group normal (Group N, patients have no anemia), group of mild anemia (Group Mi, patients have mild anemia) and group of moderate anemia (Group Mo, patients had moderate anemia). Combined spinal and epidural anesthesia were administered. Cognitive function tests were performed 1 day before the surgery and repeated at the 5th and 30th days after surgery. Peripheral venous blood samples from patients were collected before the surgery, right after surgery and at the 24th and 72nd hours after surgery. The contents of S-100β, IL-6, TNF-α and IL-1β in serum samples were determined by ELISA. It was found that there were no significant differences in general characteristics of patients among Group N, Group Mi and Group Mo ( > 0.05). Nine patients developed postoperative cognitive dysfunction after surgery, and the incidence was 14.75% (9/61). The incidence of postoperative cognitive dysfunction (POCD) was 40% in Group Mo, which was higher than that in Group N and Group Mi. The difference was statistically significant ( < 0.05). Inflammatory factors in patients with POCD were higher in post-surgery than before-surgery ( < 0.05), while there was no statistical significance in the difference of inflammatory factors of patients without POCD before and after surgery ( > 0.05). Taken together, this study suggested that moderate anemia could be a risk factor of POCD in patients undergoing hysteromyoma surgeries. This study will help surgeons developing measures for preventing the occurrence of POCD.
认知功能障碍是老年人群中的常见疾病。本研究旨在比较不同程度贫血对子宫肌瘤手术患者认知功能的影响。选取2019年3月至2020年12月在汕头大学医学院第二附属医院接受子宫肌瘤手术的61例18 - 60岁患者进行本研究。患者分为三组:正常组(N组,患者无贫血)、轻度贫血组(Mi组,患者有轻度贫血)和中度贫血组(Mo组,患者有中度贫血)。采用腰麻联合硬膜外麻醉。在手术前1天进行认知功能测试,并在术后第5天和第30天重复测试。在手术前、手术后即刻以及术后第24小时和72小时采集患者外周静脉血样本。采用酶联免疫吸附测定法(ELISA)测定血清样本中S - 100β、白细胞介素 - 6(IL - 6)、肿瘤坏死因子 - α(TNF - α)和白细胞介素 - 1β(IL - 1β)的含量。结果发现,N组、Mi组和Mo组患者的一般特征无显著差异(>0.05)。9例患者术后出现认知功能障碍,发生率为14.75%(9/61)。Mo组术后认知功能障碍(POCD)发生率为40%,高于N组和Mi组。差异具有统计学意义(<0.05)。发生POCD的患者术后炎症因子水平高于术前(<0.05),而未发生POCD的患者术前和术后炎症因子差异无统计学意义(>0.05)。综上所述,本研究表明中度贫血可能是子宫肌瘤手术患者发生POCD的危险因素。本研究将有助于外科医生制定预防POCD发生的措施。