丙泊酚和七氟烷对老年腹部手术患者认知功能的影响  

Influence of Propofol and Sevoflurane on cognitive function of elderly patients received abdominal surgery

作　　者：谭峥嵘 李泳[2] 张雪娜[3] 

机构地区：[1]东莞康华医院麻醉科,广东东莞523000 [2]南方医科大学附属深圳妇幼保健院麻醉科,广东深圳518028 [3]首都医科大学附属北京朝阳医院麻醉科,北京100026

出　　处：《中国医药导报》2013年第13期88-89,107,共3页China Medical Herald

基　　金：国家自然科学基金资助项目(编号81000473)

摘　　要：目的探讨丙泊酚和七氟烷对老年腹部手术患者认识功能的影响。方法运用随机数字表法将2010年9月～2012年9月在东莞康华医院收治的80例老年腹部手术患者分为丙泊酚组和七氟烷组，每组各40例。采用自编问卷和简易精神状态量表（MMSE）对患者围术期变量和术后认知情况进行收集。结果七氟烷组患者在恶心呕吐发生率、低血压发生率、苏醒时间、拔管时间和术后住院时间均明显低（少）于丙泊酚组（P〈0．05），七氟烷组患者应答后24h内MMSE评分（应答后1h、应答后6h和应答后12h）均明显低于丙泊酚组各相应时点的，差异有统计学意义（P〈0．05）；两组患者在应答后24h的MMSE评分恢复至麻醉前水平，差异无统计学意义（P〉0．05）。结论使用七氟烷对老年腹部手术患者进行麻醉具有安全高效和不良反应少等优点，但易出现可逆性认知功能障碍，在对患者进行麻醉时，可以根据患者的具体情况选择麻醉方式。Objective To investigate the influence of Propofol and Sevoflurane on the cognitive function of elderly patients receiving abdominal surgery. Methods 80 elderly patients receiving abdominal surgery in Dongguan Kanghua Hospital from September 2010 to September 2012 were divided into the Propofol group and the Sevoflurane group according to the random number table, each group had 40 cases. The perioperative variables and cognitive situation of the patients were collected using the self-made questionnaire and mini-mental state quantity scale. Results The Sevoflurane group were significantly lower or shorter than the Propofol group in the incidence of nausea and vomiting, incidence of hypotension, recovery time, extubation time and postoperative hospital stay （P 〈 0.05）; The Sevoflurane group were significantly lower than the propofol group in the MMSE scores at each time point within 24 hours （1, 6 and 12 hours after response）, with significant differences （P 〈 0.05）, however, the MMSE scores recovered to the pre- anesthetic level 24 hours after response, with no significant differences between the two groups （P 〉 0.05）. Conclusion In the anesthesia of elderly patients receiving abdominal surgery, Sevoflurane has the advantages of safety, high effec- tiveness, few adverse reactions and the other advantages, however, it is prone to reversible cognitive dysfunction, and therefore we can choose an anesthesia method according to the specific circumstances of the patient.

关 键 词：丙泊酚 七氟烷 腹部手术 认知功能 

分 类 号：R656[医药卫生—外科学]