丙泊酚、异氟醚对老年患者术后早期认知功能的影响  

Influence of propofol and isofluraic on early cognition function in elderly patients after operation

作　　者：何静[1] 王淑琼[1] 鲁开智[1] 陶国才[1] 

机构地区：[1]第三军医大学西南医院麻醉科,重庆400038

出　　处：《重庆医学》2010年第17期2299-2301,共3页Chongqing medicine

摘　　要：目的比较丙泊酚、异氟醚两种全身麻醉(全麻)药物对老年患者术后早期认知功能的影响及其血清神经组织蛋白质S100(S100β蛋白)浓度的变化。方法将择期行腹腔镜手术的老年患者100例,随机分为两组,全麻诱导后分别以丙泊酚(P组)、异氟醚(I组)维持麻醉;分别于麻醉前、术后6 h,术后1、2、3、5 d测定患者简易智力状态检查(MMSE)评分及血清S100β蛋白浓度。结果两组手术时间、麻醉时间及输液量等差异均无统计学意义(P>0.05);患者术后苏醒时间、拔管时间I组均长于P组(P<0.05)。两组患者麻醉前MMSE评分、血清S100β蛋白浓度异无统计学意义(P>0.05)。与麻醉前比较,P组患者术后早期(第1、2、3天)MMSE评分显著降低(P<0.05),血清S100β蛋白浓度显著升高(P<0.05);Ⅰ组患者术后较术前及P组各时间点MMSE评分显著降低(P<0.05),血清S100β蛋白浓度显著升高(P<0.05)。结论丙泊酚与异氟醚均可引起老年患者术后早期认知功能障碍及S100β蛋白浓度增高。但丙泊酚的影响较异氟醚的程度更轻且持续时间更短。Objective To compare the changes of the post-operative cognitive function and serum S100β after propofol and isoflurane anesthesia in elderly patients.Methods A total of 100 elderly patients undergoing abdominal key-hole surgery under general anesthesia were randomly assigned to three groups.Following the induction,anesthesia was maintained with propofol（group P） or isoflurane（group I）.Awaking time and extubation after operation were recorded.The mini-mental state examination（MMSE） and serum S100β were used to assess preoperative and postoperative cognitive function after the operation 6 h and 1,2,3,5 d.Results There were no significant differences among the three groups in age,sex,body weight,volume of infusion and duration of anesthesia and surgery（P〉0.05）.Awaking time and extubation after operation in the group P were shorter than those in group I.Compared with preoperation,the MMSE scores was significant lower（P〈0.05） and the levels of serum S100β was significant higher（P〈0.05） in the group P at 6 h and 1 d;the MMSE scores and the levels of serum S100β at 6 h and 1,2,3,5 d in the group I were higher（P〈0.05） than those in preoperation and the group P.Conclusion Both propofol and isoflurane anesthesia may contribute to postoperative cognitive dysfunction and the increase of serum S100β in elderly patients.But the influences of propofol anesthesia are smaller and shorter than those of isoflurance.

关 键 词：认知障碍 神经组织蛋白质S100 麻醉药 丙泊酚 异氟醚 

分 类 号：R614[医药卫生—麻醉学]