不同靶浓度异丙酚复合芬太尼麻醉时CPB下心脏瓣膜置换术患者术后早期认知功能的比较  

Effects of different concentration of propofol on early postoperative cognitive function in patients undergoing heart valve replacement

作　　者：陈进华[1] 张天静 马刚[1] 倪新莉[1] 孟尽海[1] CHEN Jinhua;ZHANG Tianjing;MA GENG;NI Xinli;MENG Jinhai(Department of Anesthesiology, General Hospital of Ningxia Med- ical University, Yinchuan 750004, Chin)

机构地区：[1]宁夏医科大学总医院麻醉科,宁夏银川750004

出　　处：《宁夏医学杂志》2018年第4期301-303,共3页Ningxia Medical Journal

基　　金：宁夏医科大学临床医学院学位点建设导师孵育科研项目(2017)

摘　　要：目的比较不同靶浓度异丙酚复合芬太尼麻醉时体外循环(CPB)下心脏瓣膜置换术对患者术后早期认知功能的影响。方法择期行二尖瓣瓣膜置换术患者,随机分为低、中、高靶浓度异丙酚组(PL组、PM组和PH组),术中异丙酚血浆靶浓度分别为1.8、2.4、3.2μg/mL。分别在不同时间点采集颈内静脉血样,测定S-100β蛋白浓度,分别于术前、术后72 h时采用简易精神状态量表(MMSE)评价认知功能情况。结果与PL组患者比较,PH组血浆S-100β蛋白浓度降低(P<0.05),PM组血浆S-100β蛋白浓度差异无统计学意义(P>0.05);3组患者间MMSE评分比较差异无统计学意义(P>0.05)。结论靶控输注异丙酚(血浆靶浓度分别为1.8、2.4、3.2μg/mL)复合芬太尼麻醉对CPB下心脏瓣膜置换术患者术后早期认知功能的影响无明显差异。Objective To investigate the effects of different concentrations of propofol on early postoperative cognitive function in patients undergoing mitral valve replacement with cardiopulmonary bypass （CPB）. Methods 42 patients scheduled for mitral valve replacement with CPB, were selected and randomly divided into three groups ： low - dose （ 1.8μg/mL, PL group）, medium - dose （2.4 μg/mL PM group） and high -dose （3.2 μg/mL PH group） based on the targeting plasma concentrations of propofol in induction and maintain. Postoperative cognitive function was assessed by the MMSE on the day before operation, 24 and 72 hours after operation. Meanwhile,blood samples were collected for measurement of the serum S - 100β protein level. Results There were no significant differ- ences on MMSE score among three groups at each time point （P 〉0.05）. Compared with PL group,the serum S - 100β protein were lower in PH groups at T2 - 4 （P 〈 0.05 ）. Conclusion Different target plasma concentrations of propofol offer equal effect on early post- operation cognitive performance.

关 键 词：异丙酚 芬太尼 心肺转流术 认知功能障碍 手术后并发症 

分 类 号：R614.2[医药卫生—麻醉学]