2016 年第 8 期 第 14 卷

帕瑞昔布钠对老年胃癌根治术后早期认知功能的影响

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关键词：帕瑞昔布钠胃癌术后认知功能早期

• 摘要：
• 【摘要】目的探讨帕瑞昔布钠对老年胃癌根治术后早期认知功能的影响。方法：选择我院2011年1月至2014年12月收治的行胃癌根治术的老年患者148例，随机分为观察组及对照组各74例，对照组在麻醉诱导前30min给予静脉注射生理盐水5ml，观察组在麻醉诱导前30min给予静脉注射帕瑞昔布钠40mg，两组术后均采用舒芬太尼进行镇痛，检测患者麻醉前、术毕、术后 6 、 12 、 24 h TNF-α ，IL-6及S100β的含量,应用MMSE量表评估其认知功能。结果：两组术前24h MMSE评分差异无统计学意义（P>0.05）；术后6h、24h与术前24h比较两组MMSE评分差异均有统计学意义（P<0.05）；术后48h 与术前24h比较，对照组MMSE评分差异有统计学意义（P<0.05），观察组MMSE评分差异无统计学意义（P>0.05）；两组术后6h、24h、48h MMSE评分差异均有统计学意义（P<0.05）。两组TNF-α术后较术前均有所上升，且在T1,T2时间点上对照组较观察组上升更为显著，差异具有统计学意义（P<0.05）。两组IL-6, S100β术后较术前均有所上升，T1,T2,T3时间点上对照组均较观察组上升更为显著，差异具有统计学意义（P<0.05）。结论：帕瑞昔布钠可明显改善老年胃癌根治术后早期认知功能，其机制可能与患者术后炎症反应与神经损伤有关。
• Objective To discuss the effect of parecoxibsodium on early cognitivefunction after radicaloperationforcarcinomaof stomach of senilepatients. Methods: 148 senilepatients which were cured by radicaloperationforcarcinomaof stomach in our hospital from Jan., 2011 to Dec., 2014 were divided into observation group and control group randomly, 74 patients in each group. The patients in control group were treated with normalsaline, I.V., 5 ml 30 minutes before anesthesiainduction. The patients in observation group were treated with parecoxibsodium, I.V., 40 mg 30 minutes before anesthesia induction. The contents of TNF-α，IL-6 and S100β were detected in two groups before anesthesia, after surgery, and 6 hours, 12 hours, 24 hours after surgery. Results: In observation group, the differences of MMSE at 6 hours and 24 hours after surgery between 24 hours pre-operation were statistically significant （P<0.05）. In control group, the differences of MMSE at 6 hours, 24 hours and 48 hours after surgery between 24 hours pre-operation were statistically significant （P<0.05）. The differences of MMSE at 6 hours, 24 hours and 48 hours after surgery compared between two groups were statistically significant（P<0.05）. After surgery, the TNF-α in two groups rose and the control groups’ TNF-α at T1,T2 rose significantly than observation groups’, the differences were statistically significant（P<0.05）. The IL-6, S100β in two groups rose after surgery, at T1,T2,T3 the control groups’ rose significantly than observation groups’, the differences were statistically significant（P<0.05）. Conclusion: Parecoxibsodium could improve the early cognitive