| Objective: To investigate the effects of enhanced recovery after surgery(ERAS)pathway on early post-hepatectomy cognitive function of elderly patients after hepatectomy.Methods: Ninety-two patients(age≥60years)undergoing elective hepatectomy for liver cancer were randomly assigned into 2 groups: group ERAS,n=48 and group C,n=48.patients in group ERAS accepted perioperative and anaesthetic optimization of enhanced recovery after surgery pathway,and patients in group C accepted perioperative and anaesthetic management of normal surgery concept.The Mini-Mental State Examination(MMSE)was used to test the cognitive function of the patients at one day before operation(T0),one day after operation(T4),three days after operation(T5)and seven days after operation(T6),and the blood levels of S100β protein,neuron-specific enolase(NSE),IL-1β,IL-6,and TNF-α were detected at T0,30 minutes after operation(T1),6 hours after operation(T2),12 hours after operation(T3)and T4.Results: Compare with group C,MMSE scores in group ERAS were increased at T4,T5,the blood levels of S100βprotein,IL-1β and IL-6 in group ERAS were decreased at T1,T2,the blood levels of NSE in group ERAS were decreased at T2,T3,the blood levels of TNF-α in group ERAS were decreased at T1-T3;compare with the baseline value at T0,MMSE scores were decreased at T4,T5 in group C and decreased at T4 in group ERAS,the blood levels of S100βprotein in two groups were increased at T1-T3,the blood levels of NSE in two groups were increased at T2-T4,the blood levels of IL-1β,IL-6,and TNF-α in two groups were increased at T1-T4;and the postoperative length of stay in group ERAS were decreased.Conclusion: Enhanced recovery after surgery pathway is helpful in improving early postoperative cognitive function of elderly patients after hepatectomy,and the mechanism may be related to decreased the blood levels of S100βprotein,NSE,IL-1β,IL-6,and TNF-α. |
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