七氟醚与丙泊酚复合麻醉对老年骨科患者术后认知功能和清醒质量的影响  

Influence of sevoflurane and diprivan combined anesthesia on postoperative cognitive function and sober quality in elderly orthopedic patients

作　　者：伍佳莉[1] 王茂华[1] 丁玉辉[2] 

机构地区：[1]泸州医学院附属医院麻醉科,四川泸州646000 [2]泸州医学院附属医院手术室,四川泸州646000

出　　处：《现代医药卫生》2015年第14期2093-2094,2097,共3页Journal of Modern Medicine & Health

基　　金：四川省泸州市科技厅项目[2013-S-48(20/30)]

摘　　要：目的观察七氟醚与丙泊酚复合麻醉对老年骨科患者术后认知功能和清醒质量的影响。方法纳入2011年1月至2015年1月全身麻醉行骨科手术的老年患者90例,根据患者麻醉方式不同分为七氟醚复合麻醉组(S组)与丙泊酚复合麻醉组(P组),各45例。观察两组患者一般手术情况(手术时间、麻醉时间、出血量、睁眼时间、拔管时间等),采用简易精神状态量表(MMSE)对患者术后24、48、72 h认知功能进行比较。结果两组患者手术时间、麻醉时间、出血量、睁眼时间、拔管时间等比较,差异均无统计学意义(P>0.05);两组患者术后MMSE评分均下降,S组术后48 h MMSE评分[(27.15±0.86)分]明显高于P组[(26.55±0.87)分],差异有统计学意义(t=3.29,P<0.05)。结论七氟醚与丙泊酚复合麻醉均能造成老年骨科患者术后认知功能降低,但均能在3 d内恢复。七氟醚复合麻醉能早期恢复患者认知功能。2种麻醉方法对术后清醒质量均无明显影响。Objective To observe the influence of sevoflurane and diprivan combined anesthesia on postoperative cogni-tive function and sober quality in elderly orthopedic patients. Methods 90 elderly patients undergoing orthopedic surgery under general anesthesia from January 2011 to January 2015 were selected and divided into the sevoflurane combined anesthesia group（group S） and the diprivan combined anesthesia group（group P）according to different anesthetic ways,45 cases in each group.The general surgical conditions（operation time,anesthesia time,amount of bleeding,eye opening time,extubating time,etc.） were observed in the two groups. The patients′ cognitive function at 24,48,72 h after surgery were compared by using mini-mental state examination（MMSE）. Results The operation time,anesthesia time,amount of bleeding,eye opening time and extubating time had no statistically significant differences between the two groups（P〉0.05）. The MMSE scores after operation in the two groups were dropped. The MMSE score at 48 h after surgery in the group S was（27.15±0.86） points,which was significantly higher than（26.55±0.87）points in the group P,the difference was statistical significance（t=3.29,P〈0.05）. Conclusion Sevoflurane and diprivan combined anesthesia can cause the declining of postoperative cognitive function in elderly orthopedic patients,but which can recover within 3 d. Sevoflurane combined anesthesia can early recover the patient′s cognitive function. Both anesthetic methods have no obvious influence on postoperative sober quality.

关 键 词：醚类 二异丙酚 麻醉 全身 老年人 医院 骨科 认知 

分 类 号：R473.6[医药卫生—护理学]