Postoperative cognitive dysfunction in elderly patients with colorectal cancer: A randomized controlled study comparing goal-directed and conventional fluid therapy

作者全名："Wu, Bin; Guo, Yuanyuan; Min, Su; Xiong, Qiuju; Zou, Lei"

作者地址："[Min, Su] Chongqing Med Univ, Affiliated Hosp 1, Dept Anesthesiol, Youyi Rd 1, Chongqing 400016, Peoples R China; [Wu, Bin; Guo, Yuanyuan; Xiong, Qiuju; Zou, Lei] Chongqing Med Univ, Affiliated Hosp 1, Dept Anesthesiol, Chongqing, Peoples R China"

通信作者："Min, S (通讯作者)，Chongqing Med Univ, Affiliated Hosp 1, Dept Anesthesiol, Youyi Rd 1, Chongqing 400016, Peoples R China."

来源：OPEN MEDICINE

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001191850000001

JCR分区：Q2

影响因子：1.7

年份：2024

卷号：19

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：goal-directed fluid therapy; colorectal cancer; postoperative cognitive dysfunction; elderly patients

摘要："To investigate the impact of goal-directed fluid therapy (GDFT) on postoperative cognitive dysfunction (POCD) in elderly patients with colorectal cancer, we conducted a randomized controlled trial. Eighty elderly patients who underwent elective laparoscopic radical resection of colorectal cancer were randomly assigned to either the GDFT group or the conventional fluid therapy group. The primary outcome was the incidence of POCD during the initial 7 postoperative days, while secondary outcomes included inflammatory marker levels such as interleukin-6 (IL-6) and S100 beta protein, hemodynamics, level of lactic acid, postoperative functional recovery, and complications. Among 88 randomized patients, 80 were evaluable for the primary outcome. The incidence of POCD was significantly lower in the GDFT group (15.0%) compared to the conventional fluid therapy group (30.0%), with the highest occurrence observed on day 3 postoperatively in both groups (P < 0.05). IL-6 and S100 beta concentrations were consistently lower in the GDFT group than in the conventional fluid therapy group at the corresponding time points (P < 0.05). The GDFT group exhibited more stable perioperative hemodynamics and lower lactate levels (P < 0.05). Moreover, patients in the GDFT group exhibited better postoperative functional recovery indicators and a lower incidence of postoperative complications (P < 0.05). In summary, GDFT appears to reduce the incidence of early POCD, accelerate postoperative recovery, and enhance overall prognosis."

基金机构：Collaborative Fund of Chongqing Municipal Health and Health Committee; Chongqing Science and Technology Bureau of China [2020FYYX152]

基金资助正文：This study was supported by Collaborative Fund of Chongqing Municipal Health and Health Committee and the Chongqing Science and Technology Bureau of China (grant 2020FYYX152).