Effect of dexamethasone on postoperative cognitive function after plasmakinetic enucleation of prostate in elderly patients
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摘要: 目的 探讨预防性使用地塞米松对老年患者前列腺剜除术后认知功能的影响。 方法 选取全麻下应用前列腺剜除术治疗的100例老年患者作为研究对象,采用随机数字表法分为地塞米松组和对照组,各50例。地塞米松组患者在术前2 h单次静脉注射0.1 mg/kg地塞米松,对照组患者则静脉注射等容量生理盐水。采用简易智能精神状态检查量表(MMSE)分别于术前1 d和术后1、3、7 d测定2组患者认知功能评分,并检测血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)水平。 结果 地塞米松组术后认知功能障碍的发生率低于对照组,差异有统计学意义(P<0.05); 地塞米松组术后1、3 d时的IL-6、TNF-α和CRP水平低于对照组,差异有统计学意义(P<0.05)。 结论 术前应用地塞米松可减轻患者前列腺剜除术后炎症反应,降低术后认知功能障碍早期风险。Abstract: Objective To explore the effect of prophylactic dexamethasone on postoperative cognitive function after plasmakinetic enucleation of the prostate. Methods A total of 100 aged patients treated with plasmakinetic enucleation of the prostateunder general anesthesia were randomized to dexamethasone group(n=50)and control group(n=50), given intravenous injection of 0.1 mg/kg dexamethasone at 2 h before surgery, and the same dosage of normal saline respectively. The cognitive function scores of the two groups were measured by Mini Mental State Examination Scale(MMSE)at the first day before operation and at 1, 3, 7 d after operation, and the levels of interleukin-6(IL-6), tumor necrosis factor -α(TNF-α), C reactive protein(CRP)were measured. Results Compared to the control group, the dexamethasone group showed significant reduction in the incidence of postoperative cognitive dysfunction, and IL-6, TNF-α and CRP levels at 1st, 3rd postoperative day in the dexamethasone group(P<0.05). Conclusion Preoperative administration of dexamethasone can reduce the inflammatory response and decrease early risk of postoperative cognitive dysfunction after plasma kinetic enucleation of the prostate.
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1. 侯蕾娜，王培. 地塞米松对宫颈癌患者术后疼痛与认知功能的影响. 福建医科大学学报. 2021(06): 540-544 . 
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