七氟醚吸入麻醉对小儿认知功能和炎症反应的影响
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The postoperative effect of sevoflurane inhalational anesthesia on cognitive function and inflammatory response of pediatric patients
背景与目的
探讨七氟醚对不同时间全身麻醉后儿童认知功能和炎症反应的影响。
方 法
纳入93名接受全身麻醉手术的儿科患者，根据全身麻醉时间分组：A组（<1 h，n = 27），B组（1-3 h，n = 36）和C组 （≥3小时，n = 30）。比较认知功能和血清炎症指数的变化。
结 果
A组和B组术后认知功能障碍（POCD）的发生率低于C组，差异有统计学意义（p <0.05）。POCD组不同时间点caspase-3、TNF-α和IL-6水平显着高于非POCD组，差异有统计学意义（p <0.05）。POCD组Caspase-3、TNF-α和IL-6水平在不同时间点发生显着变化，恢复期最高，而非POCD组在不同时间点无明显变化。
结 论
长时间的七氟醚吸入麻醉时间（≥3h）可增加POCD的发生，并与血清caspase-3，TNF-α和IL-6的表达水平有关。
原始文献摘要
Fan CH, Peng B, Zhang FC. The postoperative effect of sevoflurane inhalational anesthesia on cognitive function and inflammatory response of pediatric patients. Eur Rev Med Pharmacol Sci. 2018 Jun;22(12):3971-3975. doi: 10.26355/eurrev_201806_15281.
OBJECTIVE To investigate the effect of sevoflurane on cognitive function and inflammatory response of children after general anesthesia at different times.
PATIENTS AND METHODS Ninety-three pediatric patients who underwent general anesthesia surgery were enrolled and divided into groups based on time under general anesthesia: group A (<1 h, n=27), group B (1-3 h, n=36), and group C (≥ 3 h, n=30). Changes in cognitive function and serum inflammatory index were compared.
RESULTS The occurrence of postoperative cognitive dysfunction (POCD) in group A and B was lower than in group C and the difference was statistically significant (p<0.05). The levels of caspase-3, TNF-α, and IL-6 in the POCD group at the different time points were significantly higher than in the non-POCD group and the differences were statistically significant (p<0.05). Caspase-3, TNF-α, and IL-6 levels in the POCD group at the different time points significantly changed and were highest during the recovery period, while there were no significant changes in the non-POCD group at the different time points.
CONCLUSIONS The prolonged sevoflurane inhalational anesthesia time (≥ 3 h) enhanced the occurrence of POCD and was related to the expression levels of serum caspase-3, TNF-α, and IL-6.
麻醉学文献进展分享
贵州医科大学高鸿教授课题组
编辑：李华宇 审校：代东君