The Effect Of Preoperative Psychological Intervention On The Early Postoperative Cognitive Function And NSE In The Elderly Patients With Colorectal Cancer

Objective:To explore the effects of preoperative psychological intervention on postoperative cognitive dysfunction and neuron-specific enolase in elderly patients with colorectal cancer surgery.To provide a reference for preoperative psychological intervention to reduce the incidence of postoperative cognitive dysfunction in elderly patients with colorectal cancer.Methods:Sixty patients undergoing colorectal cancer surgery with general anesthesia were selected,aged65 to 75 years,ASA I or II,and divided into psychological intervention group（group I）and control group（group C）according to the random number table,thirty cases in each group.The group C was given routine preoperative visit and postoperative follow-up;the group I underwent routine visits to give psychological intervention at the same time,the third intervention was performed after entering operation room.BP,HR were recorded on the time points of two days before operation（T₀）,five minutes after the patients entering the operating room（T₁）,immediately before induction of anesthesia（T₂）,incision（T₃）,two hours after incision（T₄）,the end of surgery（T₅）,remove the tracheal tube（T₆）and one day after surgery（T₇）;The score of Self-rating Anxiety Scale（SAS）was recorded at two days before operation,after entering the operating room;At the same time,the operation time,anesthesia time,dosage of propofol,dosage of sufentanil,dosage of midazolam,the VAS score after 1 days,and 2 days were recorded;The blood samples were collected from two days before operation,5 minutes before anesthesia,the end of surgery,24h and48h after surgery,and the NSE content was determined;The MMSE scoring and TNT completion date were recorded two days before surgery,one day after surgery,three days and seven days.Results:After entering operation room,compared with two days before operation,SAS score of group C was significantly higher,and the difference was statistically significant（P<0.05）;The difference of SAS score between the two groups after entering operation room was statistically significant（P<0.05）;Compared with two days before operation,the MMSE score of group C were significantly reduced on the one day and three days after the surgery（P<0.05）,the MMSE score of group I were significantly reduced on the one day after the surgery（P<0.05）;Compared with group I,the MMSE score of group C were significantly reduced on the one day and three days after the surgery（P<0.05）;Compared with two days before operation,the TMT completion time in Two groups were significantly prolonged on the one day after surgery（P<0.05）,The group C was significantly longer than the I group（P<0.05）;Compared with one day after surgery,the TMT completion time in two groups were significantly shortened on the three days after surgery（P<0.05）;Compared with two days before operation,the blood levels of NSE in groups C was significantly increased on the immediately before induction of anesthesia,the end of surgery,the one day and two days after the surgery（P<0.05）;Compared with group C,the blood levels of NSE in groups I was significantly decreased on the immediately before induction of anesthesia,the end of surgery,the one day and two days after the surgery（P<0.05）;One day after operation,the incidence of POCD of group I was significantly lower than that of group C（P<0.05）.Conclusion:Preoperative psychological stress has negative effects on postoperative cognitive function in elderly patients with colorectal cancer surgery,preoperative psychological intervention can alleviate psychological stress levels in elderly patients with colorectal cancer surgery,reduce craniocerebral injury,decrease the occurrence of postoperative cognitive dysfunction,available for clinical reference.