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促红细胞生成素对心脏术后患者认知功能障碍的影响
伍志超,冯艳,王涵,袁卫国,包晓航
0
(南充市中心医院麻醉科;陆军军医大学新桥医院麻醉科)
摘要:
【摘要】 目的 探讨促红细胞生成素(Epo)对心脏术后患者认知功能障碍(POCD)的影响。方法 本研究为前瞻性的随机对照临床试验。选择2016年1月~2019年1月南充中心医院和新桥医院行心脏手术的400名患者进行初步资格筛选,最终根据入组标准选择接受心脏手术患者120例,随机分为对照组(C组,n=60)和Epo组(E组,n=60)。E组患者术前3天连续静脉给予500U/kg的Epo治疗,C组患者术前3天连续给予生理盐水。采用蒙特利尔认知评估量表(MoCA)评估两组患者给予Epo或生理盐水前(T0)、术后3~5天(T1)、术后3个月(T2)及术后6个月(T3)的认知功能。观察术后两组患者的气管拔管时间、机械通气时间、ICU停留时间和住院时间。结果 与C组相比,E组患者T1和T2MoCA评分有显著改善(P<0.05),两组T3 MoCA评分比较差异无统计学意义(P>0.05)。与C组相比,E组患者的气管拔管时间、机械通气时间显著缩短(P<0.05),两组ICU停留时间和住院时间比较差异无统计学意义(P>0.05)。结论 术前使用Epo能减轻心脏手术患者短期POCD的发生。
关键词:  促红细胞生成素  心脏手术  认知功能障碍  随机对照临床试验
DOI:
基金项目:四川省卫计委科研题目(18PJ183)
Effect of erythropoietin on post operative cognitive dysfunction after cardiac surgeries
WU Zhichao,FENG Yan,WANG Han,YUAN Weiguo,BAO Xiaohang
(Department of Anesthesiology, Nanchong Central Hospital;Xinqiao Hospital, Army Military Medical University)
Abstract:
【Abstract】 Objective To identify the effect of Erythropoietin (Epo) in prevention of Postoperative cognitive dysfunction (POCD) early and late after cardiac surgeries. Methods In this clinical randomized doubleblind controlled trial, 120 patients Patients were randomly divided into control group (group C, n=60) and Epo group (group E, n=60). Patients in group E received Epo 500 U kg-1 for three consecutive days before surgery, while patients in group C received normal saline. The montreal cognitive assessment (MoCA) were used to measure patients′ cognitive function the day before injected Epo or normal saline (T0), three to five days after(T1), 3 months (T2) and 6 months(T3) after surgery for both groups。 The time to extubation, days of mechanical ventilation,length of ICU and hospital stay were observed.Results As compared to Group C, MoCA scores showed significant improvement at T1 and T2 in group E (P<0.05), while there was no significant difference in at time T3(P>0.05). Compared to Group C, the extubation time and mechanical ventilation time of patients were significantly decreased in group E (P<0.05). There was no significant difference in length of ICU and hospital stay(P>0.05). Conclusion Preoperative administration of Epo protects patients from shortterm POCD following cardiac surgeries.
Key words:  Erythropoietin  Cardiac surgery  Cognitive dysfunction  Randomized controlled trial

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