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| 奥沙利铂术前化疗对老年胃肠道肿瘤患者术后认知功能障碍的影响 | |
| 引用本文： | 郭亮,林飞,于美钢,戴惠军,杜学柯,潘灵辉. 奥沙利铂术前化疗对老年胃肠道肿瘤患者术后认知功能障碍的影响[J]. 中国癌症防治杂志, 2018, 10(4): 299-304. DOI: 10.3969/j.issn.1674-5671.2018.04.11 |
| 作者姓名： | 郭亮 林飞 于美钢 戴惠军 杜学柯 潘灵辉 |
| 作者单位： | 广西医科大学附属肿瘤医院麻醉科 |
| 摘 要： | 目的 探讨奥沙利铂术前化疗对老年胃肠道肿瘤患者术后认知功能障碍(postoperative cognitive dysfunction, POCD)的影响。方法 选取择期全凭静脉麻醉下行胃癌、结肠癌或直肠癌根治术的老年患者100例,根据术前有无奥沙利铂化疗史分为术前化疗组(PC组)和非化疗组(NC组),每组50例;同时招募25名老年志愿者为对照组(C组),采用神经心理学测试评估认知功能, 观察PC组和NC组患者术后第7 天 POCD发生情况,多因素Logistic回归分析其发生的独立危险因素。结果 PC组46例、NC组48例和C组25名志愿者均完成所有神经心理学测试。与C组第8天神经心理学测试结果比较,PC组和NC组术后7 d视觉-语言学习测试(包括瞬时和延迟记忆)及数字-符号编码测试评分明显下降,寻迹连线测试和斯特普色词测试完成时间明显延长(P<0.05)。与NC组比较,PC组术后7 d视觉-语言学习测试(瞬时记忆)和数字-符号编码测试评分明显降低(P<0.05)。PC组POCD发生率高于NC组(45.7% vs 25.0%, P<0.05),术后住院时间亦明显延长(P<0.05)。多因素Logistic回归分析结果显示,年龄(≥75岁)和奥沙利铂术前化疗是术后7 d POCD发生的独立危险因素。结论 奥沙利铂术前化疗可导致老年胃肠道肿瘤患者POCD发生率升高,延长术后住院时间。 |
Effect of preoperative chemotherapy with oxaliplatin on postoperative cognitive dysfunction in elderly patients with gastrointestinal cancer |
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| Guo Liang,Lin Fei,Yu Meigang,Dai Huijun,Du Xueke,Pan Linghui. Effect of preoperative chemotherapy with oxaliplatin on postoperative cognitive dysfunction in elderly patients with gastrointestinal cancer[J]. Journal of Chinese Medical Abstracts·Oncology, 2018, 10(4): 299-304. DOI: 10.3969/j.issn.1674-5671.2018.04.11 | |
| Authors: | Guo Liang Lin Fei Yu Meigang Dai Huijun Du Xueke Pan Linghui |
| Abstract: | Objective To investigate the effect of preoperative chemotherapy with oxaliplatin on postoperative cognitive dysfunction(POCD) in elderly patients with gastrointestinal cancer. Methods 100 eligible individuals undergoing elective radical resection for gastric, colorectal and rectal carcinoma with total intravenous anesthesia were randomly assigned into two groups according to the history of preoperative chemotherapy with oxaliplatin: preoperative chemotherapy group(group PC) and non-preoperative chemotherapy group(group NC), while 25 elderly healthy volunteers served as the controlled group(group C). The neuropsychological tests were performed to assess the cognitive function in surgical groups at 7 days after surgery,and a multivariate Logistic regression model was conducted to analyze the risk factors of POCD. Results A total of 46 patients in group PC, 48 patients in group NC and 25 volunteers in group C completed neuropsychological tests. Compared with results at 8th day of neuropsychological tests in group C, scores of visual verbal learning test and letter-digit coding test were significantly declined, completion time of concept shifting test and stroop color word test were significantly increased in patients group(P<0.05). Compared with group NC, at 7 day after surgery, PC group showed lower visual verbal learning test(short-term memory) and letter-digit coding test scores(P<0.05), higher POCD rates (45.7% vs 25.0%,P<0.05), and longer hospital stays (P<0.05). Multivariate Logistic analysis showed that age (≥75 years) and preoperative chemotherapy with oxaliplatin were the independent risk factors of POCD after surgery. Conclusions Preoperative chemotherapy with oxaliplatin in elderly patients with gastrointestinal cancer may increase the incidence of POCD, and prolong the postoperative length of hospital stay. |
| Keywords: | Gastric neoplasms Intestinal neoplasms Oxaliplatin Preoperative chemotherapy Postoperative cognitive dysfunction Elderly patients |
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