麻醉深度对老年食管癌患者早期术后认知功能障碍的影响  

Effects of Depth Anesthesia on Postoperative Cognitive Dysfunction in Elderly Patients with Early Esophageal Cancer

作　　者：张宗銮[1] 王英[1] 

机构地区：[1]福建省肿瘤医院麻醉科,福州350014

出　　处：《海峡药学》2016年第10期89-91,共3页Strait Pharmaceutical Journal

基　　金：国家自然科学基金(81400921);福建省自然科学基金(2015J05144)

摘　　要：目的探讨麻醉深度对老年食管癌患者早期术后认知功能障碍(POCD)的影响。方法我院行择期开放性食管癌根治术的120例老年患者为研究对象,BMI 18~25kg/m2,年龄60~75岁,ASAⅠ或Ⅱ级,随机均分为两组,分别为浅麻醉组(L组)及深麻醉组(D组)。L组术中脑电双频指数(BIS)值维持在45~60,D组BIS值维持在30~45。于术前24h和术后24、72h采用简易精神状态量表(MMSE)对患者的认知功能进行评分。同时比较两组老年患者基本情况及术中补液量、出血量、手术时间、低血压发生率和术后疼痛评分等情况。结果 D组术后24和72h POCD的发生率均明显低于L组,差异有统计学意义(P<0.05)。两组患者的基本情况及术中补液量、出血量、手术时间、低血压发生率和术后疼痛评分等均无显著差异。结论与术中BIS值维持在45~60间相比,BIS值维持在30~45间可降低老年食管癌患者早期术后POCD的发生率。OBJECTIVE To explore the effects of depth anesthesia on postoperative cognitive dysfunction in elderly patients with early esophageal cancer. METHODS 120 cases of elderly patients with esophageal cancer radical were selected from March 2015 to March 2016 in our hospital as the research object,aged 60 to 75 years of,BMI18 to 25 kg / m^2,ASA grade I or Ⅱ,were divided into two groups at random： shallow anesthesia group（ group L） and deep anesthesia group（ group D）. Group L was set of brain electric double frequency index（ BIS） values at 45 to60,group D BIS values remain at 30 to 45. After 24 h and 72 h in preoperative time,the mental status of the simple scale（ MMSE） was detected on cognitive function in patients with grade. The intraoperative replenishment quantity,blood loss,operative time,postoperative pain score and the incidence of hypotension were compared. RESULTS 24 and 72h after the operation,incidence of POCD in group D group were significantly lower than L,the difference was statistically significant（ P〈0. 05）. Basic information of two groups of patients and intraoperative replenishment quantity,blood loss,operative time,postoperative pain score and the incidence of hypotension were no significant difference. CONCLUSION With intraoperative BIS value compared to maintain between 45 to 60,maintain between 30 to 45 BIS value can reduce the incidence of postoperative POCD in elderly patients with early esophageal cancer.

关 键 词：麻醉深度 术后认知功能障碍 脑电双频指数 老年患者 食管癌根治术 

分 类 号：R969.4[医药卫生—药理学]