关键词: 食管肿瘤, 认知, 右美托咪定, 磷酸肌酸

Abstract: ［Abstract］〓Objective〖HTSS〗〓To investigate the effects of dexmedetomidine, creatine phosphate sodium and the combination of both on postoperative delirium in elderly patients with radical resection of esophageal carcinoma.
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Eighty elderly patients who underwent selective esophageal carcinoma resection surgery were selected. All patients were divided into four groups randomly with the help of random number table.There were 20 individuals in each group.Patients in group C were given 20 mL NS within 10 minutes before induction of anesthesia; patients in group D were administered  dexmedetomidine(0.4 μg/kg), group P sodium phosphocreatine(4.0 g), and Group DP both of them at the same time within the same volume respectively. MiniMental State Examination(MMSE) scores were evaluated for every patient in all four groups on the day before surgery(T0) and 24 h after surgery(T3). Heart rate(HR) and systolic blood pressure(SBP) were recorded before the administration(T1) and after the administration(T2). A 4 ml of internal jugular vein blood sample was taken before  infusion of the experimental drug(T1) and 48 h after the surgery(T4) to determine the concentration of S100β protein. Visual Analogue Scale(VAS) scores were recorded at T3, T4 after surgery.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓At T1, there was not significant difference among all the four groups in HR and SBP（P>005). At T2, HR and BP of group D were lower than their counterparts at T1. At T2, HR and BP of group D were lower than their counterparts of group C, group P, and group DP, and the difference was significant(P< 0.05). At T0, there was not significant difference in MMSE scores of four groups（P>005). At T3, MMSE  of group C, group D, and group DP were lower,compared with the MMSE scores at T0. MMSE scores of group C, group D, and group DP were significant higher than that of group C, and moreover, MMSE scores of group DP was higher than that of group P, which were all significant with(P＜005).  At T0, there was not significant difference among four groups on S100β concentration（P>005). At T3, the S100β concentration were all higher than that in four groups at T0.At T3, the S100β concentration of group D, group P, and group DP were all lower than that of group C. And the S100β concentration of group DP was lower than that of group D and group P(P＜005). At T3 and T4, the VAS scores of group D and group DP were significant lower than that of group C with (P＜0.05).
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Single use of dexmedetomidine or creatine phosphate sodium could decrease the prevalence of postoperative delirium in elderly patients with radial resection of esophageal carcinoma.Moreover, with the combination of both drugs, better results were observed.

Key words: esophageal neoplasms, cognition, dexmedetomidine, phosphocreatine