异氟烷与丙泊酚对非体外循环冠脉搭桥患者术后认知功能的影响  

Impaired cognition function after isoflurane inhalation versus propofol intravenous anesthesia in off-pump CABG patients

作　　者：晁储璋[1] 李蕾[2] 类维富[2] 费剑春[2] 

机构地区：[1]泰山医学院附属医院,泰安271000 [2]山东大学齐鲁医院麻醉科

出　　处：《中华行为医学与脑科学杂志》2010年第11期970-971,共2页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：基金项目：山东省卫生厅课题（2007HW026）

摘　　要：目的 比较异氟烷静吸复合麻醉与丙泊酚全凭静脉麻醉对非体外循环冠脉搭桥患者术后认知功能的影响.方法 择期行冠脉搭桥术的冠心病患者30例,美国麻醉医师学会（ASA）心脏功能评定标准Ⅱ-Ⅲ级,按患者就诊顺序编号随机分为A、B两组,每组15例.全麻维持分别用异氟烷静吸复合（A组）或丙泊酚全凭静脉（B组）麻醉.两组患者分别于手术前1 d、术后第4天测定患者简易智力状态量表（MMSE）评分.结果 A组术后出现认知功能障碍的患者为5例（33%）,B组为3例（20%）.两组患者术前MMSE评分[A组（29.13±0.83）,B组（29.13±1.13）]差异无显著性（P＞0.05）;A组术后第4天MMSE评分（28.73±1.03）较手术前显著降低（f=2.45,P＜0.05）,B组术后第4天MMSE评分（28.93±1.16）较手术前降低,但差异无显著性（t=1.87,P＞0.05）.结论 异氟烷静吸复合麻醉与丙泊酚全凭静脉麻醉均可影响非体外循环冠脉搭桥患者的术后认知功能,但丙泊酚全凭静脉麻醉对认知功能的影响小于异氟烷静吸复合麻醉,更适合于临床应用.Objective To compare the postoperative cognition function after propofol intravenous versus isoflurane inhalation anesthesia in off-pump coronary artery bypass grafting （CABG） patients. Methods 30 ASA Ⅱ - Ⅲ patients undergoing off-pump CABG were randomly assigned to two groups. Following induction of anesthesia,isoflurane inhalation（ group A ） or propofol intravenous （group B ） were adjusted to maintain comparable depth of anesthesia state. The mini-mental state examination （MMSE） was used to assess the cognitive function 1 day before and 4 days after the operation. Results There were 5 patients suffered postoperative cognitive dysfunction in group A, and 3 cases in group B . But compared with the preoperative（ group A （29.13 ± 0. 83 ）, group B （29.13 ±1. 13 ） ） ,the MMSE score at 4 days in group A （ 28.73 ± 1.03 ） were lower（ t = 2.45, P 〈 0.05 ）, there was no difference in group B（ 28.93 ± 1.16）at 4 days（ t = 1.87, P 〉 0. 05 ）. Conclusion Both propofol intravenous anesthesia and isoflurane inhalation anesthesia in off-pump CABG may contribute to postoperative cognitive dysfunction, propofol intravenous anesthesia is advantageous over isoflurane inhalation anesthesia.

关 键 词：冠状动脉旁路移植术 认知功能 异氟烷 丙泊酚 

分 类 号：R614[医药卫生—麻醉学]