国际麻醉学与复苏杂志
國際痳醉學與複囌雜誌
국제마취학여복소잡지
INTERNATIONAL JOURNAL OF ANESTHESIOLOGY AND RESUSCITATION
2014年
8期
708-712
,共5页
郑旭%彭慧萍%马正良%顾小萍
鄭旭%彭慧萍%馬正良%顧小萍
정욱%팽혜평%마정량%고소평
青少年%脊柱侧凸矫形术%术后认知功能障碍%白介素-1β%白介素-6
青少年%脊柱側凸矯形術%術後認知功能障礙%白介素-1β%白介素-6
청소년%척주측철교형술%술후인지공능장애%백개소-1β%백개소-6
Adolescent%Scoliosis orthopedic surgery%Postoperative cognitive dysfunction%Interleukin-1beta%Interleukin-6
目的 观察青少年特发性脊柱侧凸矫形术后认知功能障碍(postoperative cognitive dysfunction,POCD)的发生,并探讨其发生与外周血白介素(interleukin,IL)-1β和IL-6水平变化的关系. 方法 拟选入择期行脊柱后路矫形术患者67例,根据是否发生POCD将患者分为POCD组和非POCD组.监测入院时(T0)、术前(T1)、术毕(T2)及术后第2天(T3)4个时刻的血清IL-1β及IL-6浓度并于术前1d、术后7d评估患者POCD的发生情况. 结果 共有66例患者完成所有测试,其中19例患者发生POCD,发生率为28.8％.统计结果表明:两组患者入院和术前血清IL-1β和IL-6浓度差异无统计学意义,而术毕及术后较基础水平均升高,但组间差异无统计学意义(P＞0.05);此外,组间比较术中及术后各记录指标发现,与非POCD组[(218±270) ml]比较,POCD组[(380±341) ml]患者自体血的输入量较多(P＜0.05). 结论 青少年特发性脊柱侧凸患者术后7d认知功能障碍发生率为28.8％,需要引起足够的重视,本试验发现外周血IL-1β及IL-6水平与POCD发生无关,但结果提示术中自体血回输量可能与POCD发生有关,需要进一步研究.
目的 觀察青少年特髮性脊柱側凸矯形術後認知功能障礙(postoperative cognitive dysfunction,POCD)的髮生,併探討其髮生與外週血白介素(interleukin,IL)-1β和IL-6水平變化的關繫. 方法 擬選入擇期行脊柱後路矯形術患者67例,根據是否髮生POCD將患者分為POCD組和非POCD組.鑑測入院時(T0)、術前(T1)、術畢(T2)及術後第2天(T3)4箇時刻的血清IL-1β及IL-6濃度併于術前1d、術後7d評估患者POCD的髮生情況. 結果 共有66例患者完成所有測試,其中19例患者髮生POCD,髮生率為28.8％.統計結果錶明:兩組患者入院和術前血清IL-1β和IL-6濃度差異無統計學意義,而術畢及術後較基礎水平均升高,但組間差異無統計學意義(P＞0.05);此外,組間比較術中及術後各記錄指標髮現,與非POCD組[(218±270) ml]比較,POCD組[(380±341) ml]患者自體血的輸入量較多(P＜0.05). 結論 青少年特髮性脊柱側凸患者術後7d認知功能障礙髮生率為28.8％,需要引起足夠的重視,本試驗髮現外週血IL-1β及IL-6水平與POCD髮生無關,但結果提示術中自體血迴輸量可能與POCD髮生有關,需要進一步研究.
목적 관찰청소년특발성척주측철교형술후인지공능장애(postoperative cognitive dysfunction,POCD)적발생,병탐토기발생여외주혈백개소(interleukin,IL)-1β화IL-6수평변화적관계. 방법 의선입택기행척주후로교형술환자67례,근거시부발생POCD장환자분위POCD조화비POCD조.감측입원시(T0)、술전(T1)、술필(T2)급술후제2천(T3)4개시각적혈청IL-1β급IL-6농도병우술전1d、술후7d평고환자POCD적발생정황. 결과 공유66례환자완성소유측시,기중19례환자발생POCD,발생솔위28.8％.통계결과표명:량조환자입원화술전혈청IL-1β화IL-6농도차이무통계학의의,이술필급술후교기출수평균승고,단조간차이무통계학의의(P＞0.05);차외,조간비교술중급술후각기록지표발현,여비POCD조[(218±270) ml]비교,POCD조[(380±341) ml]환자자체혈적수입량교다(P＜0.05). 결론 청소년특발성척주측철환자술후7d인지공능장애발생솔위28.8％,수요인기족구적중시,본시험발현외주혈IL-1β급IL-6수평여POCD발생무관,단결과제시술중자체혈회수량가능여POCD발생유관,수요진일보연구.
Objective To observe the occurrence of postoperative cognitive dysfunction (POCD) in adolescent scoliosis patients after orthopedic surgery and study its association with levels of serum interleukin (IL)-1β/IL-6 during perioperative period.Methods Sixty-seven adolescent scoliosis patients,who were scheduled for orthopedic surgery with general anesthesia were proposed to be enrolled.The levels of serum IL-1β and IL-6 were measured on the day for admission(T0),before surgery(T1),at the end of the surgery (T2) and the second day after surgery (T3) respectively and neurocognitive testing was performed at 1 d before surgery and 1 week after operation.Age,sex,years of education,past medical history,and visual analogue scale score after surgery,duration of surgery and other intraoperative indexes and also postoperative complications were recorded.According to the diagnostic criteria of POCD,patients were divided into two groups:POCD and NPOCD.All the data were put for statistical analysis.Results Sixty-six patients completed all these tests.Nineteen patients developed POCD,so the occurrence was 28.8％ at 7 d postoperatively.Statistical analysis showed that there were no differences in the levels of serum IL-1β and IL-6 at T0 and T1 in all the patients,while the concentrations increased at T2 and T3,but there were no differences between the two groups.In addition,comparisons between the two groups showed that the infusion of the volume of autologous blood in POCD group [(380±341) ml]was more than that in NPOCD group [(218±270) ml](P＜0.05).Conclusions The incidence of POCD is 28.8％ on the seventh day after scoliosis orthopedic surgery.It reminds us that we should cause enough attention on such surgeries.We did not found the relationship between the levels of serum IL-1beta/IL-6 and the occurrence of POCD,but the result sμggested that the volume of infused autologous blood might be associated with the occurrence of POCD,and further research was needed.
