七氟醚与异丙酚对腹部手术老年糖尿病患者早期术后认知功能的影响  

The effect of sevoflurane and propofol on postoperative cognitive function after abdominal surgery for elderly patients with diabetes

作　　者：周桥灵[1] 刘洪珍[1] 廖美娟[1] 杨承祥[1] 王汉兵[1] 梁桦[1] 赖晓红[1] 贺俭[1] 

机构地区：[1]中山大学附属佛山医院麻醉科,广东省佛山市528000

出　　处：《实用医学杂志》2016年第17期2911-2914,共4页The Journal of Practical Medicine

基　　金：2013年广东省医学会福尔利-中青年科研基金资助

摘　　要：目的：比较七氟醚与异丙酚对老年糖尿病腹部手术患者早期术后认知功能影响。方法：择期行腹部手术的糖尿病患者70例，年龄60—75岁，ASA分级Ⅰ或Ⅱ级，采用随机数字表法，将糖尿病患者分为两组（n=35）：七氟醚组（DS组）和异丙酚组（DP组）。于术前（T1）、术后24h（T2）、48h（T3）及1周（T4）进行以下测试：MMSE评分；连线测验；词语记忆试验；Stroop色词测验。记录各项评分和数据。结果：与T1比较，T2时点两组患者及L时点的糖尿病患者MMSE评分下降，T2-3时点两组患者连线测试A、B时间延长，T2时点两组患者Stroop色词测验一、二、三时间延长和错误数增加，T3时点两组患者Stroop色词测验二、三时间方面延长，T2-3时点糖尿病患者词语记忆试验各项词语数减少，差异有统计学意义（P〈0．05）。两组药物组之间认知功能障碍发生率则差异无统计学意义（P〉0．05）。结论：七氟醚与异丙酚均可导致老年糖尿病患者术后48h内短暂的认知功能障碍，两者的影响无差异。Objective To investigate the effects of sevoflurane and propofol on postoperative cognitive function after abdominal surgery for elderly patients with diabetes. Methods Seventy diabetic patients （aged 60 - 75 yr, ASA Ⅰ or Ⅱ ） underwent abdominal surgery and are included in the research. Diabetic patients were randomly divided into two groups （n = 35）： sevoflurane group（group DS） and propofol group （group DP）. MMSE score, the attachment test, words memory test and Stroop color word test were carried and the results were recorded before operation （T1）, postoperative 24 h （T2）, 48 h （T3） and 1 w （T4）. Results Compared with T,, patients＇ MMSE score reduced at T2 and T3. Time spent in attachment test is longer at T2 and T3. Mistaken incidences in Stroop color words test 1, 2 and 3 are higher and time longer at T2. Time spent on Stroop color words test 2 and 3 is longer in Ts.Words memory test reveals decline at T2 and T3, whose difference is statistically significant （P 〈 0.05）. Cognitive dysfunction incidence in the two groups shows no statistical significance （P 〉 0.05）. Conclusion Sevoflurane and propofol can result in postoperative cognitive dysfunction for elderly patients with diabetes within 48 h after abdominal surgery, there were no difference between the effects of them.

关 键 词：七氟醚 异丙酚 糖尿病 术后认知功能 

分 类 号：R614[医药卫生—麻醉学]