系统性保温对老年患者术后血清S-100β蛋白、神经元特异性烯醇化酶的影响

摘要

Objective To observe the effects of perioperative systemic warming on S-100β proteinum and neuron-specific enolase in elderly patients.Methods 50 elderly patients underwent selective abdominal operation in Jingmen Petrochemical Hospital were randomly divided into two groups,each group had 25 cases:control group was only given usual care; experimental group was given systemic warming methods to keep body temperature.The changes of BP,HR,SpO2,S-100β proteinum and neuron-specific enolase were compared between the two groups before anesthesia and 3,6,24 h after operation.Results Compared with the baseline,S-100β proteinum and neuron-specific enolase in the control group increased significantly at 3,6 and 24 h after operation(P＜0.05),but in the experimental group,the differences were not significant(P＞0.05).The S-100β proteinum and neuron-specific enolase levels were significantly higher in the control group than those in the experimental group at 3,6 and 24 h after operation(P＜0.05).Conclusion On the basis of current evidence,perioperative systemic warming may reduce the S-100β proteinum and neuron-specific enolase levels in elderly patients,and reduce the damage of central nerve cells.%目的 观察系统性保温措施对老年患者术后血清S-100β蛋白、神经元特异性烯醇化酶的影响.方法 将择期全麻下行腹部外科手术老年患者随机分成两组,各25例,对照组除手术室环境加温(23℃～28℃)外未采取其他保温措施；试验组采用系统性保温措施(手术室空调加温、静脉输液及冲洗液加温、保温毯及暖风机的应用).比较两组患者麻醉前、术后3、6、24 h的血压(Bp)、心率(HR)、血氧饱和度(SpO2)、血清S-100β蛋白和神经元特异性烯醇化酶的变化.结果 对照组术后3、6、24 h各时间点的血清S-100β蛋白、神经元特异性烯醇化酶水平较麻醉前均明显升高(P＜0.05),且明显高于试验组水平(P＜0.05).试验组术后3、6、24 h各时间点的S-100β蛋白、神经元特异性烯醇化酶水平较麻醉前无明显变化(P＞0.05).结论 系统性保温措施能改善老年患者术后术后血清S-100β蛋白、神经元特异性烯醇化酶的表达水平,减轻中枢神经细胞的损伤.