氢吗啡酮或羟考酮复合丙泊酚对结肠镜诊疗术后患者认知功能的影响  

Effect of Oxycodone Hydrochloride or Hydromorphone Compound Propofol on Early Postoperative Cognitive Function of Patients Underwent Colonoscopic Treatment

作　　者：陈莹莹[1] 张宗泽[1] 刘汉兴[2] 陈畅[1] 周凌雪[1] 王焱林[1] 

机构地区：[1]武汉大学医学院附属中南医院麻醉科,湖北武汉430071 [2]武汉大学医学院附属中南医院神经内科,湖北武汉430071

出　　处：《贵州医科大学学报》2017年第2期194-197,共4页Journal of Guizhou Medical University

基　　金：国家自然科学基金(81371195)

摘　　要：目的:比较氢吗啡酮或羟考酮复合丙泊酚对结肠镜诊疗术后患者认知功的影响。方法:150例行结肠镜诊疗术患者均分为对照组、羟考酮复合组和氢吗啡酮复合组;3组患者分别注射芬太尼1μg/kg(对照组)、羟考酮0.1 mg/kg(复合氢吗啡酮组)、氢吗啡酮0.02 mg/kg(氢吗啡酮复合组),随后静脉注射异丙酚1.5 mg/kg;记录3组患者麻醉诱导时间、诊疗操作时间、苏醒时间、恢复时间、异丙酚用量、术中心血管不良事件、恶心呕吐及呼吸抑制发生情况、蒙特利尔认知评估(Mo CA)量表得分及患者麻醉满意度。结果:3组患者麻醉诱导时间、诊疗操作时间、苏醒时间、恢复时间、心血管不良事件及异丙酚用量比较差异无统计学意义(P>0.05);与对照组比较,氢吗啡酮复合组和羟考酮复合组恶心呕吐和呼吸抑制的发生率降低(P<0.05);羟考酮复合组早期术后认知功能障碍(POCD)发生率高于对照组和氢吗啡酮复合组患者(P<0.05)。结论:羟考酮用于结肠镜诊疗术患者发生术后早期POCD高于芬太尼和氢吗啡酮。Objective：To compare the effect of Oxycodone Hydrochloride or hydromorphone compound propofol on early postoperative cognitive function of patients underwent colonoscopic treatment.Methods：150 patients treated with colonoscopy were divided into three groups（n = 50） by random number table：control group,oxycodone hydrochloride group（group O） and hydromorphone compound propofol group（group H）.Three groups were treated respectively with intravenous fentanyl 1 μg/kg（control group）,oxycodone hydrochloride 0.1 mg/kg（group O）,hydromorphone 0.02 mg/kg（group H）; later on,intravenous injecting propofol 1.5 mg/kg.Recording anesthetic induction time,diagnosis and operation time,awakening time,recovery time,propofol volume,intraoperative MACE,nausea and vomiting,respiratory inhibition,Mo CA scales and patients anesthesia satisfactory degree.Results：As for the Hemodynamic indexes,the BIS value,anesthesia induction time,diagnosis and operation time,awakening time,recovery time,the incidence of MACE and the dosage of propofol showed no statistically significant difference（P〉0.05）.Comparing with control group,incidence rate of nausea and vomiting and respiratory inhibition in Group H and Group O decreased（P〈0.05）; postoperative cognitive dysfunction incidence rate of Group O is higher than control group and Group H（P〈0.05）.Conclusion：Treating patients underwent colonoscopic treatment by Oxycodone hydrochloride is more likely to occur early postoperative cognitive dysfunction than Hydromorphone hydrochloride and fentanyl.

关 键 词：认知障碍 呼吸功能不全 蒙特利尔认知评估量表 羟考酮 氢吗啡酮 异丙酚 

分 类 号：R614[医药卫生—麻醉学]