中华航海医学与高气压医学杂志
中華航海醫學與高氣壓醫學雜誌
중화항해의학여고기압의학잡지
CHINESE JOURNAL OF NAUTICAL MEDICINE AND HYPERBARIC MEDICINE
2013年
6期
394-397
,共4页
高压氧%老年患者%术后认知功能障碍
高壓氧%老年患者%術後認知功能障礙
고압양%노년환자%술후인지공능장애
Hyperbaric oxygen%Elderly patients%Postoperative cognitive dysfunction
目的 观察高压氧(hyperbaric oxygen,HBO)治疗老年患者术后认知功能障碍(postoperative cognitive dysfunction,POCD)的疗效.方法 依据病例纳入和排除标准,挑选46例术后有认知功能障碍的老年患者,术后做过HBO治疗的23例为干预组,术后未做HBO治疗的23例为对照组.对照组给予常规治疗,干预组在常规治疗的基础上加HBO治疗.观察2组治疗前后的认知功能评分和ICU监护时间,并且采用酶联免疫法测定血清S-100B蛋白和神经元特异性烯醇化酶(neuron specificenolase,NSE)含量.结果 干预组治疗前后的简易智能精神状态检查量表(mini-mental stateexamination,MMSE)总分差异有统计学意义(P＜0.01);干预组治疗后MMSE总分与对照组治疗后相比也有升高,差异有统计学意义(P＜0.01).干预组平均ICU监护时问[(19.1±3.2)d],与对照组[(25.2±4.1)d]比较差异有统计学意义(P＜0.05);2组S-100B蛋白和NSE含量术后治疗前、第1天与同组麻醉前相比差异均有统计学意义(P＜0.01),与对照组相比,干预组治疗后血清S-100B蛋白和NSE显著下降(P＜0.05).结论 老年POCD患者应用HBO综合治疗,具有加快损伤细胞恢复、促进神经功能好转的功效,其机制可能是HBO综合治疗降低了血清S-100B蛋白和NSE含量.
目的 觀察高壓氧(hyperbaric oxygen,HBO)治療老年患者術後認知功能障礙(postoperative cognitive dysfunction,POCD)的療效.方法 依據病例納入和排除標準,挑選46例術後有認知功能障礙的老年患者,術後做過HBO治療的23例為榦預組,術後未做HBO治療的23例為對照組.對照組給予常規治療,榦預組在常規治療的基礎上加HBO治療.觀察2組治療前後的認知功能評分和ICU鑑護時間,併且採用酶聯免疫法測定血清S-100B蛋白和神經元特異性烯醇化酶(neuron specificenolase,NSE)含量.結果 榦預組治療前後的簡易智能精神狀態檢查量錶(mini-mental stateexamination,MMSE)總分差異有統計學意義(P＜0.01);榦預組治療後MMSE總分與對照組治療後相比也有升高,差異有統計學意義(P＜0.01).榦預組平均ICU鑑護時問[(19.1±3.2)d],與對照組[(25.2±4.1)d]比較差異有統計學意義(P＜0.05);2組S-100B蛋白和NSE含量術後治療前、第1天與同組痳醉前相比差異均有統計學意義(P＜0.01),與對照組相比,榦預組治療後血清S-100B蛋白和NSE顯著下降(P＜0.05).結論 老年POCD患者應用HBO綜閤治療,具有加快損傷細胞恢複、促進神經功能好轉的功效,其機製可能是HBO綜閤治療降低瞭血清S-100B蛋白和NSE含量.
목적 관찰고압양(hyperbaric oxygen,HBO)치료노년환자술후인지공능장애(postoperative cognitive dysfunction,POCD)적료효.방법 의거병례납입화배제표준,도선46례술후유인지공능장애적노년환자,술후주과HBO치료적23례위간예조,술후미주HBO치료적23례위대조조.대조조급여상규치료,간예조재상규치료적기출상가HBO치료.관찰2조치료전후적인지공능평분화ICU감호시간,병차채용매련면역법측정혈청S-100B단백화신경원특이성희순화매(neuron specificenolase,NSE)함량.결과 간예조치료전후적간역지능정신상태검사량표(mini-mental stateexamination,MMSE)총분차이유통계학의의(P＜0.01);간예조치료후MMSE총분여대조조치료후상비야유승고,차이유통계학의의(P＜0.01).간예조평균ICU감호시문[(19.1±3.2)d],여대조조[(25.2±4.1)d]비교차이유통계학의의(P＜0.05);2조S-100B단백화NSE함량술후치료전、제1천여동조마취전상비차이균유통계학의의(P＜0.01),여대조조상비,간예조치료후혈청S-100B단백화NSE현저하강(P＜0.05).결론 노년POCD환자응용HBO종합치료,구유가쾌손상세포회복、촉진신경공능호전적공효,기궤제가능시HBO종합치료강저료혈청S-100B단백화NSE함량.
Objective To observe Hyperbaric oxygen (HBO) in the treatment of elderly patients with postoperative cognitive dysfunction (POCD).Methods Forty-six elderly patients with POCD were equally divided into the intervention and control groups,each consisting of 23 patients,by depending on whether or not they received HBO therapy.The control group received conventional therapy,while the intervention group received HBO therapy in addition to conventional therapy.Observations were made on the cognitive function scores and the number of days in ICU care,both before arid after treatment.Then,levels of serum S-100B protein and neuron specific enolase (NSE) were detected by enzyme-linked immunosorbent assay.Results Statistical differences could be seen in the total scores of mini-mental state examinations (MMSE) for the intervention group,both before and after treatment (P ＜ 0.01).Furthermore,increase in the total scores of MMSE could be noticed for the intervention group after HBO treatment,when compared with those of the control group,with statistical significance (P ＜0.01).Average stay in ICU for the intervention group was (19.1 ±3.2) days and statistical significance could also be noted,when they were compared with those of the control group (25.2±4.1)days (P ＜0.05).Statistical significance could be noticed in S-100B protein and NSE levels for both groups,when they were compared respectively with those of the same groups,both before anesthesia and the first day after surgery (P ＜ 0.01).When they were compared with those of the control group,serum S-100B and NSE levels after treatment for the imervention group significantly decreased (P ＜ 0.05).Conclusions HBO therapy in the treatment of elderly patients with POCD could acceleratc repair of damaged cells and promote recovery of nerve function,the mechanism of which might lie in the fact that comprehensive HBO therapy decreased the serum levels of S-100B protein and NSE.
