黑激素对老年患者术后认知功能的影响,这些老年患者在脊髓麻醉下接受过尿道切除前列腺
Cristiane Tavares1, Cláudia Maia Memória1, Luiz Guilherme Villares da Costa2
1Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil.
Clinics (Sao Paulo, Brazil)
|December 27, 2024
概括
梅拉素在经尿道切除前列腺切除 (TURP) 后没有预防术后神经认知障碍 (POCD),但它改善了老年患者的记忆和注意力. 在手术后180天,所有患者的认知功能都意外地得到改善.
科学领域:
- 老年医学 老年医学
- 神经科学是一个神经科学.
- 麻醉学 麻醉学
背景情况:
- 通过尿道切除前列腺 (TURP) 住院治疗可能会扰乱昼夜节律,可能导致老年人患上术后神经认知障碍 (POCD).
- 这项研究研究了黑激素减轻这种效应的潜力.
研究的目的:
- 为了确定是否可以预防或减少梅拉托尼在接受TURP的老年患者中POCD的发病率.
- 评估黑激素对 TURP 后认知恢复的影响.
主要方法:
- 一个双盲,随机的临床试验,涉及118名60岁及以上的患者,他们接受 TURP 与脊髓麻醉.
- 认知表现被评估使用神经心理测试在手术前和在21日和180天后术后.
- 参与者在手术前一晚和手术后三天接受了10毫克的黑激素或安慰剂.
主要成果:
- 在21天后,黑激素和安慰剂组之间延迟神经认知恢复没有显著差异.
- 在手术后180天内,在两个组中都没有观察到POCD病例.
- 黑激素组显示记忆 (FOME) 和注意力/认知灵活性 (Digit Span测试) 的表现有所改善;所有患者的整体认知表现在180天内都有所改善.
结论:
- 黑素在统计学上没有影响POCD的发病率,但在特定的认知领域表现出有选择性的益处.
- 手术前的认知缺陷很常见,可能与下泌尿道症状有关.
- 180天后认知功能的整体改善表明,TURP的症状缓解可能会对认知产生积极影响.
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