不同压力二氧化碳气腹对妇科腹腔镜手术患者术后早期认知功能的影响分析

目的 讨论妇科腹腔镜手术中不同压力二氧化碳(CO2)气腹对患者术后早期认知功能的影响.方法 120例行妇科腹腔镜手术患者,按照随机数字表法将其分为L组、M组、H组,各40例.三组在手术过程中CO2气腹压力分别设置为11、13、15 mm Hg(1 mm Hg=0.133 kPa).于术前24 h、术后24 h、术后72...

Effect of different pressure CO2 pneumoperitoneum on early postoperative cognitive function of patients undergoing gynecological laparoscopic surgery

Objective To discuss the effect of different pressure carbon dioxide(CO2)pneumoperitoneum on early postoperative cognitive function of patients undergoing gynecological laparoscopic surgery.Methods A total of 120 patients undergoing gynecological laparoscopic surgery were divided into L group,M group and H group according to random numerical table,with 40 cases in each group.The pressure of CO2 pneumoperitoneum in three groups was set to 11,13,15 mm Hg(1 mm Hg=0.133 kPa)during the operation.The cognitive function was assessed by mini-mental state examination(MMSE)at 24 h before operation,24 h and 72 h after operation;the venous blood was collected at 1 h before anesthesia(T₁),1 h after operation(T₂),6 h after operation(T₃)and 24 h after operation(T₄),and the serum levels of neuron specific enolase(NSE),S-100β,cortisol(COR),norepinephrine(NE),prostaglandin E2(PGE2)were measured.The indexes in three groups were compared.Results At 24 h before operation,24 h and 72 h after operation,the MMSE score of L group were(27.63±1.62),(27.82±0.97)and(27.99±0.92)point,which were(27.38±1.29),(27.13±1.73)and(27.62±1.45)points in M group,and(27.44±1.57),(27.52±1.85)and(27.94±1.06)points in H group.At 24 h before operation,24 h and 72 h after operation,there was no statistically significant difference in MMSE score among and within the three groups(P>0.05).The NSE level at T₂ and T₃ of L group and M group were all lower than that of H group,and S-100βlevel at T₂ was lower than that of H group,and the difference was statistically significant(P<0.05).Comparison of the COR levels at T₂,T₃,T₄ of the three groups,L group3 and T₄ and the PGE2 levels at T₂,T₃ and T₄ in the H and M groups were significantly higher than those in the L group,and the differences were statistically significant(P<0.05).Conclusion In gynecological laparoscopic surgery,CO₂ pneumoperitoneum at different pressures has no significant effect on the early postoperative cognitive function of patients,but higher pressure will cause the body to have a stronger stress response,which will affect the release of neurochemical markers of brain injury and hormone levels.