氧化应激标志物与老年肿瘤手术患者术后谵妄的关系

Current health sciences journal Pub Date : 2024-10-01 Epub Date: 2024-12-31 DOI:10.12865/CHSJ.50.04.09
Andreea Doriana Stanculescu, Petru Octavian Dragoescu, Maria Andrei, Luminita Chiutu, Nicoleta Alice Dragoescu
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引用次数: 0

摘要

前言:术后谵妄是各种类型手术的常见并发症,尤其是在老年人中。术后谵妄被认为是由自由基过量产生引起的不平衡的结果。目的:确定一种氧化应激标志物,用于预测腹腔镜泌尿外科恶性疾病患者术后谵妄的发生。材料与方法:本研究纳入了29例于2021 - 2024年间行经腹腔腹腔镜根治性肾癌患者。采集血样的时间间隔为:全麻诱导前、术后即刻、术后24小时。测定丙二醛(MDA)、谷胱甘肽过氧化物酶(GSH)和超氧化物歧化酶(SOD)水平。术后谵妄的发生采用ICU混淆评定法(CAM-ICU)进行评估。结果:所有病例术后谵妄均在术后7天内出现。29例患者中,11例出现术后谵妄。与非谵妄患者相比,谵妄组患者在手术结束时丙二醛水平明显较高(结论:通过评估氧化应激标志物水平可以预测腹腔镜泌尿外科恶性疾病患者术后发生谵妄的可能性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Association Between Oxidative Stress Markers and Postoperative Delirium in Elderly Patients Undergoing Oncologic Surgery.

Introduction: Postoperative delirium is a frequent complication associated with various types of surgery, particularly among older adults. It is thought that postoperative delirium is the result from an imbalance caused by the overproduction of free oxygen radicals.

Objective: To determine an oxidative stress marker that can predict the onset of postoperative delirium in patients undergoing laparoscopic urological surgery for malignant conditions.

Materials and methods: The study involved 29 male and female patients who underwent transperitoneal laparoscopic radical surgery for localized kidney cancer between 2021 and 2024. Blood samples were collected at three intervals: before general anesthesia induction, immediately after surgery, and 24 hours postoperatively. The levels of malondialdehyde (MDA), glutathione peroxidase (GSH) and superoxide dismutase (SOD) were measured. The occurrence of postoperative delirium was evaluated using the Confusion Assessment Method for the ICU (CAM-ICU).

Results: All cases of postoperative delirium emerged within the first seven days after surgery. Out of 29 patients, 11 developed postoperative delirium. Patients in the delirium group exhibited significantly higher malondialdehyde levels at the end of surgery compared to those without delirium (p<0.05). Additionally, superoxide dismutase levels measured before anesthesia induction differed significantly between the delirium and nondelirium groups (p<0.05). Also, glutathione peroxidase (GSH) at the end of surgery significantly decreased in delirium group (p<0.05).

Conclusion: The likelihood of developing postoperative delirium in patients undergoing laparoscopic urological surgery for malignant conditions can be anticipated by evaluating oxidative stress markers levels.

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