Studies Of Correlation Between Inflammatory Factors And The Occurrence Of Postoperative Cognitive Dysfunction In Idiopathic Adolescent Scoliosis Patients In Early Postoperative Phase

Objective:To observe the alteration of plasma inflammatory factors concentrations of adolescent scoliosis patients after orthopedic surgery, study its association with postoperative cognitive dysfunction(POCD) in idiopathic adolescent scoliosis patients during perioperative period.Methods:151dolescent scoliosis patients, aged between 11-17 years old, ASA Ⅰ-Ⅱ who were scheduled for orthopedic surgery with general anesthesia were proposed to be enrolled. All patients were divided into two groups randomly, one group is ulinastatin group(W grooup), another group is non-ulinastatin group(NW grooup). Venous blood samples (2ml) were obtained when their peripheral vein were open(T1) and 2h after surgery(T2) respectively, then determined the levels of plasma inflammatory factors, including IL-1β, IL-6, IL-10 and TNF-α. Cognitive function was evaluated with a set of neuropsychological tests at 1 day before surgery and 1 week after operation. According to the diagnostic criteria of POCD. Age, sex, years of education, past medical history, duration of surgery and other intraoperative indexes and postoperative complications were recorded. Then conducted statistical analysis.Results:Of all the proposed enrolled patients,3 patients were excluded because their MMSE scores were below 23, and 3 patients rejected to complete post-operative neuropsychological tests and were excluded, thus 145 patients completed all these tests. There were 63 patients in W group,13 were diagnosed as POCD, the occurrence was 20.63%, and 82 patients in NW group,16 were diagnosed as POCD, the occurrence was 19.51% at 7 days postoperatively. The difference between two groups wasn’t statistical. The results showed that the plasma concentrations of every inflammatory factors on T1 between two groups has no statistical difference (P>0.05). Furthermore, the plasma concentrations of every inflammatory factors on T2 was much higher than T1 (P<0.05).Conclusion:There is certain occurrence of POCD in idiopathic adolescent scoliosis patients. The concentrations of plasma inflammatory factors will increase at postoperative acute phase, but this has no relevance with the early occurrence of post-operative cognitive dysfunction. Therefore, the alteration of plasma inflammation factors’s concentrations can not a predictive factor for the occurrence of POCD.