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目的探讨右美托咪定对老年甲状腺癌根治术患者认知功能和肿瘤坏死因子(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)水平的影响。方法选择驻马店市中心医院2011年1月至2014年1月收治的老年甲状腺癌根治术患者200例,随机分为观察组104例和对照组96例。对照组在麻醉诱导后给予持续氯化钠注射液静脉输注,观察组予盐酸右美托咪定0.3μg/kg持续静脉输注。对比两组患者术前、术中、术后血清TNF-α、IL-6、IL-8水平,并应用简易精神状态量表(MMSE)测定和对比术前及术后1、7 d的认知功能。结果观察组术后1 d的认知功能评分显著高于对照组,差异有统计学意义(P<0.05),两组患者术后7 d认知功能评分均恢复到正常水平。观察组手术开始后至术后24 h,血清TNF-α、IL-6、IL-8水平显著低于对照组,差异有统计学意义(P<0.05)。结论右美托咪定可以降低血清中TNF-α、IL-6、IL-8水平,从而减少炎性因子对中枢神经系统的损害,有效改善老年甲状腺根治术患者术后认知功能,具有临床应用价值。
Objective To investigate the effects of dexmedetomidine on cognitive function and the levels of tumor necrosis factor (TNF-α), interleukin-6 (IL-6) and interleukin-8 (IL-8) in elderly patients with radical thyroidectomy influences. Methods 200 patients with senile thyroid cancer underwent radical surgery at Zhumadian Central Hospital from January 2011 to January 2014 were randomly divided into observation group (n = 104) and control group (n = 96). The control group was given intravenous infusion of sodium chloride injection after induction of anesthesia. The observation group received continuous intravenous infusion of dexmedetomidine 0.3μg / kg. The serum levels of TNF-α, IL-6 and IL-8 in the two groups were compared before and after surgery, and the MMSE was used to measure and compare the preoperative, postoperative and postoperative 1, 7 days Know function. Results The score of cognitive function in observation group at 1 d after operation was significantly higher than that in control group (P <0.05). The cognitive function scores of both groups recovered to normal level on the 7th day after operation. The levels of TNF-α, IL-6 and IL-8 in the observation group were significantly lower than those in the control group after the start of operation and 24 h after operation (P <0.05). Conclusion Dexmedetomidine can reduce the levels of TNF-α, IL-6 and IL-8 in serum, reduce the damage of central nervous system by inflammatory cytokines and improve the postoperative cognitive function in elderly patients with thyroid radical. Value.