Effects of Different Anesthesia Methods on Intestinal Barrier Function and Postoperative Cognitive Dysfunction in Elderly Patients Undergoing Colorectal Cancer Surgery
CHEN Hong, LI Shiyong, LUO Ailin, et al
Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei Wuhan 430030, China
Abstract：Objective: To explore whether different anesthesia methods affect the intestinal barrier function and postoperative cognitive function of elderly patients undergoing colorectal cancer surgery. Methods: A total of 100 elderly patients with colorectal cancer undergoing radical resection from March 2018 to March 2021 were selected as the research subjects and divided into group A and group B according to the simple random number table method, with 50 cases in each group. Patients in group B were given general anaesthesia and patients in group A were given epidural compound general anaesthesia. The intestinal barrier function, postoperative cognitive dysfunction score, and anesthesia effect score were observed and compared. Results: From the comparison of intestinal barrier function scores, there was no significant difference in the levels of serum diamine oxidase, D-lactic acid, and endotoxin between the two groups before surgery (P>0.05), while the corresponding levels after surgery decreased significantly in both groups and the levels of serum diamine oxidase, D-lactic acid, and endotoxin of group A decreased more than group B (P<0.05). From the comparison of the incidence of postoperative cognitive dysfunction between the two groups of patients, the results of the generalized estimation equation test showed: ① the results of the comparison between the groups: wald=8.366, P=0.004<0.05, and the comparison between the groups was statistically significant. Compared with group B, the probability of group A is 0.004; ②repeated measurement time comparison results: wald=11.540, P=0.003<0.05, the comparison between groups is statistically significant. There are differences in the occurrence of cognitive function in patients with different anesthesia methods at different time points. Compared with T4, T2 and T3 are 0.001 and 0.077 respectively. It can be seen from the line chart of the incidence of POCD of the two groups of patients that the patients in group A showed a linear downward trend in T2-T4, which was significantly faster than the patients in group B. From the comparison of the surgical anesthesia effect of the two groups of patients, the anesthesia time, wake-up time, and extubation time of the patients in group A were less than those in group B, and the difference between the two groups of patients was statistically significant (P<0.05). Conclusion: Different anesthesia methods have certain effects on the intestinal barrier function and postoperative cognitive function of elderly patients undergoing colorectal cancer surgery. Epidural combined with general anaesthesia is of greater safety, with lower incidence of POCD, and shorter time of wake-up and extraction, which can improve the intestinal barrier function.
陈红, 李世勇, 罗爱林, 何满. 不同麻醉方式对老年结直肠癌术患者肠道屏障功能及术后认知功能障碍的影响[J]. 河北医学, 2022, 28(3): 394-398.
CHEN Hong, LI Shiyong, LUO Ailin, et al. Effects of Different Anesthesia Methods on Intestinal Barrier Function and Postoperative Cognitive Dysfunction in Elderly Patients Undergoing Colorectal Cancer Surgery. HeBei Med, 2022, 28(3): 394-398.
2022, Vol. 28 
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