[1]杜 巍,谢海辉,卢星照,等.非气管插管麻醉对胸腔镜肺叶切除术后患者认知功能及血清MMP-9、脂联素的影响[J].医学信息,2025,38(05):89-93.[doi:10.3969/j.issn.1006-1959.2025.05.013]
　DU Wei,XIE Haihui,LU Xingzhao,et al.Effects of Non-tracheal Intubation Anesthesia on Cognitive Function and Serum MMP-9 and Adiponectin in Patients After Video-assisted Thoracoscopic Surgery Lobectomy[J].Journal of Medical Information,2025,38(05):89-93.[doi:10.3969/j.issn.1006-1959.2025.05.013]
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非气管插管麻醉对胸腔镜肺叶切除术后患者认知功能及血清MMP-9、脂联素的影响()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
38卷
期数:
2025年05期
页码:
89-93
栏目:
论著
出版日期:
2025-03-01

文章信息/Info

Title:
Effects of Non-tracheal Intubation Anesthesia on Cognitive Function and Serum MMP-9 and Adiponectin in Patients After Video-assisted Thoracoscopic Surgery Lobectomy
文章编号:
1006-1959（2025）05-0089-05
作者:
杜 巍1; 谢海辉2; 卢星照1; 陈国标1; 黄锡安1; 郭裕良1; 扶志敏1; 彭山攀2
东莞市人民医院/南方医科大学附属第十医院胸心外科1，麻醉科2，广东 东莞 523016
Author(s):
DU Wei1;  XIE Haihui2; LU Xingzhao1;  CHEN Guobiao1;  HUANG Xi′an1;  GUO Yuliang1;  FU Zhimin1;  PENG Shanpan2
Department of Cardiothoracic Surgery1, Department of Anesthesiology2, Dongguan People′s Hospital/the Tenth Affiliated Hospital of Southern Medical University, Dongguan 523016, Guangdong, China
关键词:
非气管插管麻醉; 胸腔镜手术; 术后认知功能障碍; 基质金属蛋白酶-9; 脂联素
Keywords:
Non-tracheal intubation anesthesia;  Video-assisted thoracoscopic surgery;  Postoperative cognitive dysfunction;  Matrix metalloproteinase-9;  Adiponectin
分类号:
R655.3
DOI:
10.3969/j.issn.1006-1959.2025.05.013
文献标志码:
A
摘要:
目的 探讨采用非气管插管麻醉方式对胸腔镜肺叶切除手术后患者认知功能以及血清基质金属蛋白酶-9（MMP-9）和脂联素（ADP）浓度的影响。方法 选择2022年1月-12月我院60例拟行电视胸腔镜（VATS）肺叶切除术患者60例，随机均分为非插管自主呼吸麻醉VATS组（观察组）和常规插管麻醉VATS组（对照组），每组30例。比较两组麻醉手术期间生命体征指标、动脉血氧指标、麻醉时间、手术时间、术后麻醉苏醒情况。采用简易精神状态检查量表（MMSE）于术前24 h、术后24 h、72 h对两组患者认知功能进行评估。记录两组患者术后POCD情况。采用酶联免疫吸附法于手术切皮前30 min、术后24 h分别采集静脉血样检测血清MMP-9、ADP浓度。结果 两组手术麻醉前后平均动脉压、心率、PaO2、SpO2、PaCO2、麻醉时间、手术时间、术中失血量比较，差异无统计学意义（P＞0.05）。观察组术后呼之可睁眼时间、定向力恢复时间均短于对照组（P＜0.05）。两组手术后24、72h的MMSE评分低于术前，观察组术后MMSE评分高于对照组（P＜0.05）。与术前（切皮前30 min）比较，两组术后血清MMP-9浓度升高，ADP浓度降低（P＜0.05）。观察组术后24 h血清MMP-9浓度低于对照组，血清ADP浓度高于对照组（P＜0.05）。结论 非插管自主呼吸麻醉方式应用于电视胸腔镜肺叶切除手术中能够保证麻醉效果，维持生命体征和动脉血氧指标稳定，可以加快术后苏醒，可能通过抑制MMP-9表达和促进ADP分泌，减轻术后认知功能障碍。
Abstract:
Objective To investigate the effects of non-tracheal intubation anesthesia on cognitive function and serum concentrations of matrix metalloproteinase-9 (MMP-9) and adiponectin (ADP) in patients after video-assisted thoracoscopic surgery lobectomy. Methods From January to December 2022, sixty patients undergoing video-assisted thoracoscopic surgery (VATS) lobectomy in our hospital were randomly divided into non-intubated spontaneous breathing anesthesia VATS group (observation group) and conventional intubation anesthesia VATS group (control group), with 30 patients in each group. The vital signs, arterial blood oxygen index, anesthesia time, operation time and postoperative anesthesia recovery were compared between the two groups. Mini-mental state examination (MMSE) was used to evaluate the cognitive function of the two groups at 24 h before operation, 24 h and 72 h after operation. The postoperative POCD of the two groups was recorded. Venous blood samples were collected 30 min before skin incision and 24 h after operation to detect serum MMP-9 and ADP concentrations by enzyme-linked immunosorbent assay. Results There were no significant difference in mean arterial pressure, heart rate, PaO2, SpO2, PaCO2, anesthesia time, operation time and intraoperative blood loss between the two groups before and after anesthesia (P>0.05). The postoperative eye opening time and orientation recovery time in the observation group were shorter than those in the control group (P<0.05). The MMSE score of the two groups at 24 and 72 h after operation was lower than that before operation, and the MMSE score of the observation group was higher than that of the control group (P<0.05). Compared with preoperative (30 min before skin incision), the serum MMP-9 concentration was increased and the ADP concentration was decreased in the two groups after operation (P<0.05). The serum MMP-9 concentration at 24 h after operation in the observation group was lower than that in the control group, and the serum ADP concentration was higher than that in the control group (P<0.05). Conclusion The application of non-intubated spontaneous breathing anesthesia in video-assisted thoracoscopic surgery lobectomy can ensure the anesthetic effect, maintain the stability of vital signs and arterial oxygen index, and accelerate postoperative recovery, while may reduce postoperative cognitive dysfunction by inhibiting MMP-9 expression and promoting ADP secretion.

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更新日期/Last Update: 1900-01-01