| Objective: To investigate the effect of painless gastroscopy and painless colonoscopy on the cognitive dysfunction of patients with gastric cancer and colon cancer after intravenous general anesthesia.Methods: Part one:The effect of painless gastroscopy on postoperative cognitive dysfunction of aged patients with gastric cancer surgery was investigated.50 Patients were divided into two groups(25 case in each group): the test group(Experimental Group,EG)and the control group(Control Group,CG).Group EG underwent surgery after painless gastroscopy.Group CG underwent surgery after routine gastroscopy.Researchers recorded the score of MMSE scale of each patient on the day before operation by bedside.In the duration of operation,blood loss and duration of hypotension were recorded.Postoperative infection and postoperative complications were recorded.Serum s-100 ? protein concentration before anesthesia induction,24 h and 1 week after operation were recorded.One day and one week after operation,the researchers recorded the score of the MMSE scale of each patient again.The baseline levels of the two groups were compared,and the difference between the monitoring records above of the two groups were compared.The MMSE score that recorded one day and one week after operation were compared.The difference of the Serum s-100 ? protein concentration between that recorded before anesthesia induction and that recorded 24 h and 1 week after operation were compared.Part two:The effect of painless colonoscopy on postoperative cognitive dysfunction in aged patients with colon cancer operation was investigated.60 Patients were divided into two groups(30 case in each group): the test group(Experimental Group,EG)and the control group(Control Group,CG).Group EG underwent radical operation for carcinoma of colon after painless colonoscopy.Group CG underwent radical operation for carcinoma of colon after routine colonoscopy.Researchers recorded the score of MMSE scale on the day before operation by bedside.In the duration of operation,blood loss and duration of hypotension were recorded.Postoperative infection and postoperative complications were recorded.Serum s-100 ? protein concentration before anesthesia induction,24 h and 1 week after operation were recorded.One day and one week after operation,the researchers recorded the score of the MMSE scale again of each patient.The baseline levels of the two groups were compared,and the difference between the indicators of the monitoring records above of the two groups were compared.The MMSE score that recorded one day and one week after operation were compared.The difference of the Serum s-100 ? protein concentration between that recorded before anesthesia induction and that recorded 24 h and 1 week after operation were compared.Results: Part one:Twenty-five patients with gastric cancer were included in the painless gastroscopy group,one of whom was proved to have metastasis during operation and was removed,so 24 patients were included in the painless gastroscopy group.25 patients were included in the routine gastroscopy group.There was no significant difference in gender,age,and degree of culture in the patients between EG and CG.The operative time(273.51±57 min VS 272.55±53min),the operative blood loss(150.78±39ml VS 163.24±54ml)and the duration of continuous hypotension(6.12±2.3min VS 5.69±2.4min)between EG and CG was not statistically significant.There was no significant difference in incision infection(infection percentage 4.2% VS 8%)and postoperative complications(complication rate 16.7% VS 24%)between EG and CG.On the first day after the operation,the painless gastroscopy group was compared with the ordinary gastroscope group(20.8% VS 28%),and the incidence of POCD was not statistically significant.In the first week after the operation,the painless gastroscopy group was compared with the ordinary gastroscope group(4.1% VS 8%),and the incidence of POCD was not statistically significant.The MMSE score that recorded 1 day after operation(29.16±1.22 VS 28.92 ± 1.34)was not statistically significant.The MMSE score that recorded 1 week after operation(29.57±0.92 VS 29.69±0.74)was not statistically significant.There was no significant difference of serum S-100?protein concentration before anaesthesia of operation between EG and CG(0.069±0.013 VS0.068±0.021).There was no significant difference of serum S-100?protein concentration in 24 h and 1 weeks after operation between EG and CG(0.084±0.025 VS0.081±0.048;0.072±0.028 VS 0.077±0.032).Part two:In this study,30 patients with colon cancer were included in painless colonoscopy group,of whom 3 patients proved metastasis during operation and were removed,so 27 patients were included in painless colonoscopy group.30 patients were enrolled in the routine colonoscopy group.There was no significant difference in gender,age,and degree of culture in the patients between EG and CG.The operative time(267.41±47min VS 276.44±49min),the operative blood loss(148.78±47ml VS 159.22±53ml)and the duration of continuous hypotension(7.3±2.5min VS 6.43±2.6min)between EG and CG was not statistically significant.There was no significant difference in incision infection(infection percentage 7.4% VS 10%)and postoperative complications(complication rate 18.5% VS 20%)between EG and CG.On the first day after operation,the painless enteroscopy group was compared with the common enteroscopy group(22.2% VS 23.3%),and there was no significant difference in the incidence of POCD.In the first week after the operation,the painless enteroscopy group was compared with the common enteroscopy group(3.7% VS 6.7%),and there was no significant difference in the incidence of POCD.The MMSE score that recorded 1 day after operation(28.87±1.37 VS 28.73±1.44)was not statistically significant.The MMSE score that recorded 1 week after operation(29.25±0.84 VS 29.35±0.93)was not statistically significant.There was no significant difference of serum S-100?protein concentration before anaesthesia of operation between EG and CG(0.079±0.013 VS 0.0678±0.031).There was no significant difference of serum S-100?protein concentration in 24 h and 1 weeks after operation between EG and CG(0.094±0.022 VS 0.091±0.028;0.082±0.023 VS 0.087±0.052).Conclusion: The painless gastroscopy and painless colonoscopy under general anesthesia has no significant effect on the cognitive function of patients after digestive system operation. |
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