异氟醚或七氟醚复合右美托咪定麻醉对老年患者腹腔镜胆囊切除术后认知功能的影响  

Effect of sevoflurane or isoflurane adding dexmedetomidine on early postoperative cognitive dysfunction in elderly patients undergoing laparoscopic cholecystectomy

作　　者：哈斌[1] 钟卫 HA Bin,ZHONG Wei(Department of Anesthesiology,the Ninth People′s Hospital,Chongqing 400700,China)

机构地区：[1]重庆市第九人民医院麻醉科,400700

出　　处：《检验医学与临床》2018年第17期2591-2594,共4页Laboratory Medicine and Clinic

摘　　要：目的研究异氟醚或七氟醚复合右美托咪定麻醉对老年腹腔镜胆囊切除术(LC)患者术后认知功能的影响。方法选择2015年1月至2017年1月在重庆市第九人民医院择期行LC的120例老年患者,按随机数字表法分为4组:异氟醚组(A组)、七氟醚组(B组)、异氟醚复合右美托咪定组(C组)和七氟醚复合右美托咪定组(D组),每组30例。在不同时间点对比分析4组患者的平均动脉压(MAP)和心率(HR),采用简易精神状态检查量表(MMSE)评定患者的认知功能。结果 C组患者MAP和HR比A组下降明显,D组患者MAP和HR比B组也有所下降。在手术后6h和24h,B组和C组MMSE评分高于A组(P<0.05),D组MMSE评分高于B组(P<0.05),而C组和D组之间差异无统计学意义(P>0.05)。结论 LC老年患者采用七氟醚进行全身麻醉对患者认知功能的影响要稍低于异氟醚,而当复合右美托咪定能有效降低全身麻醉对患者认知功能的影响,复合右美托咪定进行全身麻醉可能是一种优选的方式。Objective The aim of this study was to compare of early cognitive function and recovery after sevoflurane or isoflurane adding dexmedetomidine anaesthesia in the elderly patients with laparoscopic cholecystectomy （LC）. Methods A total of 120 patients taking the LC were included from January 2015 to January 2017 in Chongqing Ninth People′s Hospital.All the included patients were divided into four groups by simple random sampling,including group A （isoflurane）,B （sevoflurane）,C （isoflurane ＋ dexmedetomidine） and D （sevoflurane ＋ dexmedetomidine）.Each group included 30 patients.The mean arterial pressure （MAP） and heart rate （HR） were measured at different time points.And the early cognitive function was evaluated by Mini Mental State Examination （MMSE）. Results Compared to sevoflurane anaesthesia,adding dexmedetomidine could decrease patients MAP and HR significantly （ P 〈0.05）.Moreover,isoflurane added with dexmedetomidine anaesthesia also decreased patients MAP and HR compared to anaesthesia with isoflurane alone （ P 〈 0.05）.After 6 h and 24 h of surgery,the MMSE score in group B and C were higher than group A significantly （ P 〈0.05）.Besides,the MMSE score in group D also increased significantly compared with group B （ P 〈 0.05 ）.However,there was no significant difference between group C and D. Conclusion For elderly patients,the effects of sevoflurane anaesthesia on cognitive function in patients with general anesthesia was slightly lower than that of isoflurane,and when adding with dexmedetomidine anaesthesia could reduce the impact on cognitive function in patients with general anesthesia effectively.Thus,adding with dexmedetomidine anaesthesia may be a way of optimization for elderly patients with general anesthesia.

关 键 词：七氟醚 异氟醚 认知障碍 手术后期间 

分 类 号：R614.2[医药卫生—麻醉学]