不同麻醉深度对老年腹腔镜胃肠手术术后认知功能的影响  

Effects of postoperative cognitive function in the different anesthesia depth for laparoscopic gastrointestinal operation elderly

作　　者：董楠[1] 浦勇[2] 简金金 朱云霞[1] 

机构地区：[1]江南大学附属医院无锡市第四人民医院麻醉科,江苏无锡214062 [2]江南大学附属医院无锡市第四人民医院病理科,江苏无锡214062

出　　处：《临床与病理杂志》2015年第11期1932-1936,共5页Journal of Clinical and Pathological Research

摘　　要：目的：研究不同麻醉深度对老年腹部手术患者术后认知功能的影响。方法：80例老年腹部手术患者,随机分为两组,A组患者术后BIS值维持在50-60,B组维持在40-50。观察术后7、15、30 d术后认知功能障碍（postoperative cognitive dysfunction,POCD）发生率,并检测外周血S100-β含量进行初步机制探讨。结果：所有患者麻醉后7、15 d智能评分较术前1 d显著降低,术后30 d部分逐步恢复。B组患者术后7、15 d POCD发生率较A组显著减少,外周血S100-β含量也显著减少;术后30 d,B组患者较A组患者S100-β显著降低,但POCD发生率无显著差异。结论：老年患者术中BIS值维持在40-50较50-60可以显著降低术后15 d POCD发生率。Objective： To study effects of postoperative cognitive function in the different anesthesia depth for elderly abdominal surgical patients. Methods： 80 cases of elderly patients with abdominal surgery were randomly divided into two groups. BIS value was maintained at 50-60 for patients group A. BIS value was maintained at 40-50 for patients group A. Postoperative cognitive dysfunction （POCD） incidence and peripheral blood S 100-13 content were observed in the postoperative 7, 15, 30 days and POCD preliminary mechanism was explored. Results： Wechsler Adult Intelligence Scale （WAIS） in the postoperative 7, 15 days were lower significantly than in the preoperative one day for all patients. WAIS were gradually restored after 30 days. Compared with group A, incidences of POCD and the content of peripheral blood S 100-β were significantly lower in the postoperative 7 and 15 days in group B. Compared with group A, incidences of POCD and the content of peripheral blood S100-β were significantly lower in the postoperative 7 and 15 days in group B. Compared with group A, S100-β ingroup B patients were significantly lower, but PO CD incidences was not significant difference in the postoperative 30 days. Conclusion： Compared with BIS value in 50-60, intraoperative BIS value maintained at 40-50 can significantly reduce the incidence of POCD for elderly patients in postoperative 15 days.

关 键 词：老年 腹腔镜胃肠手术 POCD 血清S100-β蛋白 

分 类 号：R614[医药卫生—麻醉学]