全凭静脉麻醉对老年妇科腹腔镜手术患者血流动力学及认知功能的影响  

Effects of total intravenous anesthesia on hemodynamics and cognitive function in elderly patients undergoing gynecologic laparoscopic surgery

作　　者：崔雪娅 李娜[1] Cui Xueya;Li Na(Department of Anesthesiology,Anyang Hospital of Traditional Chinese Medicine,Anyang 455000,China)

机构地区：[1]河南省安阳市中医院麻醉科,455000

出　　处：《临床医学》2018年第8期21-23,共3页Clinical Medicine

摘　　要：目的探讨全凭静脉麻醉对老年妇科腹腔镜手术患者血流动力学变化及认知功能的影响。方法选取2016年1月至2017年6月113例行老年妇科腹腔镜手术患者,采用随机数字表法将其分为两组,对照组56例应用静吸复合麻醉,观察组57例给予全凭静脉麻醉,比较两组患者麻醉后血流动力学改变、应激反应及认知功能变化。结果观察组麻醉起效、睁眼及拔管时间均短于对照组(P<0.05);麻醉后12、24 h观察组MMS评分高于对照组;观察组T1、T2、T3段舒张压(DBP)及收缩压(SBP)高于对照组,心率(HR)、肾上腺素及去甲肾上腺素低于对照组,差异均有统计学意义(P<0.05)。结论全凭静脉麻醉能够有效抑制老年妇科腹腔镜手术患者的应激反应,降低对血流动力学及认知功能的影响,麻醉效果较好。Objective To investigate the effects of total intravenous anesthesia on hemodynamic changes and cognitive function in elderly patients undergoing gynecologic laparoscopic surgery.Methods A total of 113 elderly patients treated by gynecologic laparoscopic surgery from January 2016 to June 2017 were selected and divided into two groups according to the random digital table method. The56 patients in the control group were treated with static and inhalation anesthesia,and the 57 patients in the observation group were given total intravenous anesthesia. The changes of blood flow mechanics,stress response and cognitive function after anesthesia were compared between the two groups.Results The anesthetic effects,eye opening and extubation time in the observation group were lower than those in the control group（ P〈0. 05）; 12 and 24 h after the anesthesia,the scores of MMS in the observation group were higher than those in the control group（ P〈0. 05）. The diastolic pressure（ DBP）and systolic pressure（ SBP） at T1,T2 and T3 in the observation group were higher than those in the control group. The heart rate（ HR）,epinephrine and norepinephrine of the observation group were lower than those of the control group,the differences were significant（ P〈0. 05）. Conclusions Total intravenous anesthesia can effectively inhibit the stress response of the elderly patients with gynecological laparoscopic surgery,reduce the impact on hemodynamics and cognitive function,and the effect of anesthesia is better.

关 键 词：全凭静脉麻醉 老年 妇科腹腔镜手术 血流动力学 认知功能 

分 类 号：R614[医药卫生—麻醉学]