The effect of preoperative application of Xuesaitong on acute inflammatory response and cognitive function of patients after gynecological laparoscopic surgery / 中国中西医结合急救杂志

ABSTRACT

Objective To investigate the effect of Xuesaitong injection on acute inflammatory response and preoperative cognitive dysfunction (POCD) in patients after gynecological laparoscopic surgery. Methods From July 2016 to September 2017, there were 246 patients having undergone gynecological laparoscopic surgery in the Department of Obstetrics and Gynecology of Guangyuan Central Hospital. And according to whether Xueseton was used or not preoperatively, they were divided into a control group (n = 118) and an observation group (n =128). The patients in the observation group were given intravenous drip with 400 mg Xuesaitong at 30 minutes before surgery, while the patients in the control group were given intravenous drip with equal amount of 5% glucose solution at 30 minutes before surgery. The enzyme-linked immunosorbent assay (ELISA) was used to detect serum levels of interleukin-1 and -6 (IL-1, IL-6) and tumor necrosis factor-α (TNF-α); the neuropsychological tests were used to assess the patients' cognitive function; visual analogue scale (VAS) score was applied to assess the postoperative pain of patients; the intra-operative situation and the postoperative related risk occurrence were recorded in the two groups. Results The comparisons of indicators between the observation group and control group were as follows the operation time (minutes 106.2±30.6 vs. 114.6±22.7), anesthesia time (minutes 126.1±21.2 vs. 122.1±25.3), intra-operative blood loss (mL 324.4±63.1 vs. 313.6±65.1) and postoperative rash (1 case vs. 2 cases), chest distress (11 cases vs. 8 cases), palpitation (10 cases vs. 8 cases), asthma (5 cases vs. 4 cases), hematuria (2 cases vs. 3 cases), incision bleeding (4 cases vs. 3 cases), lower limb deep venous thrombosis (DVT 11 cases vs. 14 cases) and VAS score (3.6±0.9 vs. 3.8±0.8), prothrombin time [PT (s) 10.7±2.2 vs. 9.7±1.5], activated partial thromboplastin time [APTT (s) 30.3±3.3 vs. 30.7±4.3], international normalized ratio (INR 0.9±0.1 vs. 1.1±0.1), all of the above comparisons in indexes between the two groups had no statistical significant differences (all P > 0.05); with prolonged treatment, the IL-1, IL-6 and TNF-α levels were gradually decreased in two groups, reached the lowest levels at 12 hours after surgery, and the changes in the observation group were more significant than those in the control group [IL-1 (pg/L) 3.8±1.0 vs. 6.5±1.2, IL-6 (pg/L) 6.3±1.3 vs. 10.3±1.6, TNF-α (pg/L) 5.6±1.3 vs. 8.4±1.2]; after surgery the scores of MMSE test (score 25.8±3.1 vs.20.8±3.3) and the word fluency test (14.9±1.8 vs. 12.8±1.8) in the observation group were significantly higher than those in the control group, while the incidence of POCD was significantly lower than that in the control group [18.7% (24/128) vs. 33.8% (40/118), all P < 0.05]. Conclusion The use of Xuesaitong before gynecological laparoscopic surgery can reduce the patients' expression levels of serum IL-1, IL-6 and TNF-α at acute inflammatory stage, reduce the occurrence of POCD and does not increase the related risk after surgery.