Neimark M I, Shmelev V V, Rakhmonov A A, Nazarchuk E A
Altai State Medical University, Barnaul, Russia.
Diagnostic Center of the Altai Territory, Barnaul, Russia.
Khirurgiia (Mosk). 2022(5):52-58. doi: 10.17116/hirurgia202205152.
To study the dynamics of markers of brain damage, determine their role in postoperative cognitive dysfunction (POCD) and evaluate the effectiveness of therapeutic correction of POCD in patients undergoing laparoscopic cholecystectomy under inhalation anesthesia with sevoflurane.
We analyzed data of two representative groups of patients (aged 55 years and older) who underwent laparoscopic cholecystectomy under inhalation anesthesia with sevoflurane. Perioperative neuropsychological testing was performed for monitoring of higher mental functions (MoCA and FAB). In the 1 group (=30), POCD was not corrected. In the 2 group (=30), Cellex 0.1 mg was subcutaneously injected once before surgery and then throughout 5 postoperative days to correct cognitive disorders.
Neuropsychological testing revealed moderate POCD in the 1 group. In the 2 group, Cellex provided a significantly lower level of brain-specific proteins compared to the 1 group. This limited brain damage and ensured no severe cognitive deficit in early postoperative period.
Laparoscopic cholecystectomy under inhalation anesthesia with sevoflurane in patients aged 55 years and older is accompanied by moderate POCD in early postoperative period. Injections of Cellex 0.1 mg before surgery and then for 5 postoperative days prevent POCD and improve quality of life.
研究脑损伤标志物的动态变化，确定其在术后认知功能障碍（POCD）中的作用，并评估在接受七氟醚吸入麻醉的腹腔镜胆囊切除术患者中POCD治疗纠正的有效性。
我们分析了两组代表性患者（年龄55岁及以上）的数据，这些患者接受了七氟醚吸入麻醉下的腹腔镜胆囊切除术。进行围手术期神经心理学测试以监测高级心理功能（蒙特利尔认知评估量表和额叶评估量表）。在第1组（n = 30）中，未对POCD进行纠正。在第2组（n = 30）中，术前皮下注射一次0.1 mg西莱克斯，然后在术后5天内持续注射以纠正认知障碍。
神经心理学测试显示第1组存在中度POCD。在第2组中，与第1组相比，西莱克斯使脑特异性蛋白水平显著降低。这限制了脑损伤，并确保术后早期无严重认知缺陷。
55岁及以上患者在七氟醚吸入麻醉下进行腹腔镜胆囊切除术，术后早期伴有中度POCD。术前注射0.1 mg西莱克斯，然后在术后5天内注射可预防POCD并改善生活质量。
