丙泊酚和七氟烷麻醉对老年胸外科手术患者术后认知功能的影响分析  

Effects of propofol and sevoflurane anesthesia on cognitive function in elderly patients after thoracic surgery

作　　者：彭霁 郑菡 王丽[1] 杨雪[1] PENG Ji ZHENG Han WANG Li et al.(Daping Hospital Affiliated to Third Military Medical University, Chongqing 400042, Chin)

机构地区：[1]第三军医大学附属大坪医院,重庆400042

出　　处：《国际精神病学杂志》2017年第5期934-936,943,共4页Journal Of International Psychiatry

摘　　要：目的探讨丙泊酚麻醉和七氟烷麻醉对老年胸外科手术患者术后认知功能的影响。方法选择医院2015年6月-2016年6月收治的110例老年胸外科手术患者作为研究对象,按照数字表法随机分为观察组和对照组,每组各55例患者。观察组给予丙泊酚联合舒芬太尼麻醉,对照组给予七氟烷联合舒芬太尼麻醉,比较两组患者术后认知功能障碍(POCD)发生率,并对认知功能产生的影响因素进行分析。结果两组患者手术时间和麻醉时间无明显差异(P>0.05);观察组自主呼吸恢复时间、睁眼时间、拔管时间和应答时间均少于对照组(P<0.05);术后1h,6h,12h观察组简易精神量表(MMSE)评分均高于对照组(P<0.05),观察组术后12h MMSE评分恢复至术前水平,对照组术后24h恢复至术前水平。观察组术后不良反应发生率为14.55%,对照组不良反应发生率为30.91%,观察组明显低于对照组(P<0.05);术后1h,6h,合并基础疾病患者POCD发生率明显高于无基础疾病患者。结论丙泊酚和七氟烷麻醉都会导致老年胸外科手术患者术后短期内认知功能的下降,均会引起POCD的发生,但丙泊酚麻醉对认知功能的影响较小,术后认知功能恢复更早。Objective To investigate the effect of propofol anesthesia and seven isoflurane anesthesia on postoperative cognitive function in elderly patients undergoing thoracic surgery. Methods 110 cases of elderly patients in Department of thoracic surgery were divided into control group and observation group. The observation group was given propofol combined with sufentanil anesthesia,the control group was given seven halothane anesthesia with sufentanil,and cognitive function were compared between two groups after operation. Results The recovery time of spontaneous breathing,eye opening time,extubation time and response time in observation group were less than those in the control group（P〈0.05）;The MMSE scores after operation in the observation group were higher than those in the control group（P〈0.05）. The incidence of adverse reaction of the patients in the observation group was 14.55%,the control group adverse reaction rate was 30.91%（P〈0.05）;after 1 h,6 h,POCD in patients with underlying disease incidence was significantly higher than that patients without underlying diseases. Conclusion The propofol anesthesia and seven isoflurane anesthesia to elderly patients undergoing thoracic surgery will lead to the decline of postoperative cognitive function in the short term and cause POCD,but compared with seven isoflurane anesthesia,the effect on the cognitive function of propofol anesthesia is less and the recovery of cognitive function after surgery is earlier.

关 键 词：丙泊酚 七氟烷 麻醉 认知功能 

分 类 号：R749[医药卫生—神经病学与精神病学]