不同浓度丙泊酚靶控输注对冠脉旁路移植术患者术后认知功能的影响  

Objective to investigate the effect of target controlled infusion of different concentrations of propofol on postoperative cognitive function in patients andergoing coronary artery bypass grafting

作　　者：黄平 HUANG Ping(Longchang People＇s Hospital, Longchang 642150, China)

机构地区：[1]隆昌县人民医院,四川隆昌642150

出　　处：《临床医药实践》2018年第4期265-267,共3页Proceeding of Clinical Medicine

摘　　要：目的:探讨不同浓度丙泊酚靶控输注对冠脉旁路移植术患者术后认知功能的影响。方法:选择冠脉旁路移植术患者180例,以随机数字抽取法分成A组(实施小剂量丙泊酚靶控输注麻醉)与B组(大剂量丙泊酚靶控输注麻醉)各90例。观察对比两组患者的丙泊酚诱导总量及效应室浓度;采用简易精神状态量表(MMSE)对患者术后24 h、48 h、72 h的认知功能进行检测。结果:A组丙泊酚诱导总量明显少于B组,P<0.05;两组患者丙泊酚效应室浓度对比,P>0.05,差异无统计学意义。A组术后24 h、48 h的MMSE评分均明显较B组高,P<0.05,而术后72 h两组MMSE评分对比,P>0.05,差异无统计学意义。A组患者缝皮时及术后24 h的S100β浓度水平明显低于B组,P<0.05,而两组患者72 h的S100β浓度水平对比,P>0.05,差异无统计学意义。结论:对冠脉旁路移植术患者实施小剂量丙泊酚靶控输注,可有效减少对患者近期认知功能的损害。Objective： To investigate the effect of target controlled infusion with different concentrations of propofol on postoperative cognitive function in patients undergoing coronary artery bypass grafting. Methods： All 180 cases of coronary artery bypass graft surgery patients in our hospital as the research object,randomly divided into group A（ digital decimation method to implement a small dose of propofol target controlled infusion anesthesia） and group B（ high dose of propofol target controlled infusion anesthesia in 90 cases）. The total amount of propofol induced and the effect chamber concentration were observed and compared,and the cognitive function of 24 h,48 h and 72 h before and after operation was detected by simple mental state scale（ MMSE） in two groups. Results： The total amount of propofol induction in group A was significantly less than that in group B,P 〈0. 05,and the difference of propofol effect room concentration between the two groups was no difference,P 〉0. 05. The MMSE scores of 24 h and 48 h in group A were significantly higher than those in group B,P〈 0. 05,and there was no difference in MMSE score between two groups after 72 h,P 〉0. 05. The levels of S100β and beta in and 24 h after operation were significantly higher in group A than in group B,P 〈0. 05,while there was no difference in the levels of S100β and 72 h between the two groups,P〉 0. 05. Conclusion： The small dose of target controlled infusion of phenol targeted at the coronary artery bypass grafting can effectively reduce the short-term cognitive impairment of patients,and has high clinical value.

关 键 词：冠脉旁路移植术 丙泊酚 靶控输注 认知功能 

分 类 号：R614[医药卫生—麻醉学]