七氟烷与丙泊酚对老年腹部手术患者术后认知功能影响的对照研究  

Case control study for impact of sevoflurane and propofol-control study in elderly patients undergoing abdominal postoperative cognitive function

作　　者：贺吉辉 王莉[2] 

机构地区：[1]杭州钢铁集团公司职工医院麻醉科,浙江杭州310022 [2]上海交通大学附属第六人民医院麻醉科,上海200233

出　　处：《中国现代医生》2014年第29期31-34,共4页China Modern Doctor

基　　金：国家自然科学基金(30972842/H0214)

摘　　要：目的研究七氟烷与丙泊酚用于老年腹部手术患者全身麻醉对术后认知功能影响。方法将146例老年腹部手术患者随机分为A组和B组,每组73例,分别采用七氟烷和丙泊酚进行麻醉维持。结果 A组苏醒时间、拔管时间均显著少于B组(P<0.05)。A组和B组术后2 h、6 h、12 h MMSE均显著低于术前(P<0.05),术后24 h、48 h认知状态恢复正常,B组术后2 h、6 h、12 h MMSE显著高于A组(P<0.05)。A组和B组术前、术后2 h、术后24 h血清S100β蛋白、IL-2水平术后2 h均较术前显著升高(P<0.05),术后24 h则回落,B组术后2 h血清S100β蛋白、IL-2水平显著低于A组(P<0.05)。结论七氟烷与丙泊酚用于老年腹部手术患者全身麻醉均可引起不同程度可逆性术后认知功能障碍,均可较快恢复,七氟烷引起的认知功能障碍程度较重,术后认知功能障碍与血清S100β蛋白、IL-2升高相关。Objective To study sevoflurane and propofol for abdominal surgery in elderly patients with general anesthe-sia on postoperative cognitive function. Methods A total of 146 elderly patients with abdominal surgery were randomly divided into group A and group B, each of 73 cases, respectively, used sevoflurane and propofol anesthesia maintained. Results Set of recovery time, extubation time in group A were significantly less than group B （P〈0.05）. Group A and group B after 2 h, 6 h, 12 h MMSE were significantly lower than the preoperative （P〈0.05）, after 24 h, 48 h normal cognitive status, after 2 h, 6 h, 12 h MMSE in group B were significantly higher than those in group A（P〈0.05）. A group and B group before and after surgery 2 h, 24 h after serum S100βprotein, IL-2 levels after 2h before surgery were sig-nificantly higher than preoperative （P〈0.05）, 24 h after the fall, group B after 2 h serum S100β protein, IL-2 levels were significantly lower than group A （P〈0.05）. Conclusion Sevoflurane and propofol for abdominal surgery under general anesthesia in elderly patients with varying degrees of reversibility may cause postoperative cognitive dysfunc-tion, can be quickly restored, the degree of dysfunction induced by sevoflurane cognitive heavier, postoperative cogni-tive dysfunction and serum S100βprotein, IL-2 increases related.

关 键 词：七氟烷 丙泊酚 术后认知功能障碍 S100茁蛋白 

分 类 号：R614.2[医药卫生—麻醉学]