论文部分内容阅读
目的:探讨右美托咪定对老年胃癌根治术患者术后认知功能及转化生长因子β(TGFβ)/Smad通路的影响。方法:选择台州市中心医院(台州学院附属医院)2018年12月至2019年12月收治的老年胃癌根治术患者100例，依据随机数字表法分为观察组50例与对照组50例；观察组于麻醉诱导后给予盐酸右美托咪定静脉输注；对照组于麻醉诱导后给予氯化钠注射液静脉输注。比较两组丙泊酚和瑞芬太尼用量、手术时间和术中出血量、术后3 d、7 d认知功能障碍(PCOD)发生情况，及术前和术后3 d TGFβ、Smad1和Smad2蛋白表达变化。结果:观察组丙泊酚用量(648.71±65.25)mg和瑞芬太尼用量(0.46±0.08)mg，均少于对照组的(837.92±57.53)mg和(0.59±0.14)mg(n t＝15.380、5.701，均n P0.05)；观察组PCOD发生率(术后3 d：8.00%，术后7 d：12.00%)低于对照组(26.00%、34.00%)(χn 2＝5.741、6.832，均n P<0.05)；观察组术后3 d TGFβ(0.45±0.09)、Smad1(0.37±0.06)和Smad2(0.36±0.04)，均低于对照组的(0.60±0.18)、(0.47±0.08)和(0.42±0.11)(n t＝5.271、7.071、3.625，均n P<0.05)。n 结论:右美托咪定用于老年人胃癌根治术可降低术后PCOD发生率，且可下调TGFβ/Smad蛋白通路表达。“,”Objective:To investigate the effect of dexmedetomidine on cognitive function and transforming growth factor β(TGF-β)/Smad pathway in elderly patients with gastric cancer after radical operation.Methods:A total of 100 elderly patients with gastric cancer undergoing radical gastrectomy in Taizhou Central Hospital from December 2018 to December 2019 were randomly divided into observation group (50 cases) and control group (50 cases) according to the random digital table method.In the observation group, dexmedetomidine hydrochloride was given intravenously after anesthesia induction.The control group was given sodium chloride injection intravenously after anesthesia induction.The dosage of propofol and remifentanil, the time of operation, the amount of intraoperative bleeding, the occurrence of cognitive impairment (PCOD) on the 3rd and 7th day after operation, and the expression of TGF-β, Smad1 and Smad2 proteins before and after operation were compared between the two groups.Results:The dosages of propofol [(648.71±65.25)mg] and remifentanil [(0.46±0.08)mg] in the observation group were lower than those in the control group [(837.92±57.53)mg and (0.59±0.14)mg] (n t=15.380, 5.701, all n P0.05). The incidences of PCOD at postoperative 3d and 7d in the observation group (8.00%, 12.00%) were lower than those in the control group (26.00%, 34.00%) (χn 2=5.741, 6.832, all n P<0.05). The expression of TGF-β(0.45±0.09), Smad1 (0.37±0.06) and Smad2 (0.36±0.04) in the observation group were lower than those in the control group [(0.60±0.18), (0.47±0.08) and (0.42±0.11)] (n t=5.271, 7.071, 3.625, all n P<0.05).n Conclusion:Dexmedetomidine can reduce PCOD and downregulate the protein expression of TGF-β/Smad pathway.