靶控输注异丙酚与七氟醚吸入对老年患者术后苏醒和认知功能影响比较  

Comparison between the effects of target-controlled infusion of propofol and inhalation of sevoflurane on postoperative recovery and cognitive function in elderly patients

作　　者：丁容 张文奇 颜聪 林冠文[1] 付强 邓小华 DING Rong;ZHANG Wenqi;YAN Cong;LIN Guanwen;FU Qiang;DENG Xiaohua(Department of Anesthesiology, Hainan General Hospital,Haikou 570000,China)

机构地区：[1]海南省人民医院麻醉科

出　　处：《现代仪器与医疗》2019年第2期62-65,共4页Modern Instruments & Medical Treatment

摘　　要：目的:比较七氟醚与异丙酚对老年患者术后苏醒和认知功能的影响,为临床麻醉方案的选择提供参考依据。方法:将我院2016年1月至2017年10月96例择期行腹部手术的老年患者随机分为七氟醚组、异丙酚组,各48例。根据组别选择相应麻醉方案,比较两组患者自主呼吸恢复时间、睁眼时间及拔管时间,围术期简易智能状态量表(MMSE)评分变化,以及术后认知功能障碍(POCD)发生率,分析两种麻醉方案对患者苏醒和认知功能的影响。结果:七氟醚组与异丙酚组自主呼吸恢复时间、睁眼时间、拔管时间比较,差异无统计学意义(P>0.05)。两组患者术后3h^6hMMSE评分均较术前1d下降,七氟醚组术后3h、术后6hMMSE评分低于异丙酚组,差异有统计学意义(P<0.05),术后3dMMSE评分低于术前,差异无统计学意义。七氟醚组术后3h、术后6hPOCD发生率高于异丙酚组,差异有统计学意义(P<0.05)。结论:七氟醚与异丙酚均不会影响老年患者术后苏醒,但均可在一定程度上影响患者认知功能,异丙酚对患者术后早期认知功能的影响略低于七氟醚。Objective: This study objective was to compare the effects of sevoflurane and propofol on postoperative recovery and cognitive function in elderly patients, and to provide reference for the selection of clinical anesthesia. Methods: 96 elderly patients who underwent elective abdominal surgery in our hospital from January 2016 to October 2017 were randomly divided into sevoflurane group and propofol group, with 48 patients in each group. According to the selection of appropriate anesthesia programs for each group, the spontaneous breathing recovery time, eye opening time and extubation time of patients in the two groups, the changes of perioperative Mini-mental State Examination (MMSE) score, and the incidence of postoperative cognitive impairment (POCD) were compared, and the effects of the two anesthesia programs on patients' waking and cognitive function were analyzed. Results: There were no significant differences in spontaneous breathing recovery time, eye opening time and extubation time between the sevoflurane group and the propofol group (P>0.05). MMSE scores of patients in the two groups were decreased at 3-6 h after surgery compared with 1 d before surgery. MMSE scores of patients in the sevoflurane group at 3 h and 6 h after surgery were lower than those in the propofol group, and the differences were statistically significant (P<0.05). MMSE scores at postoperative 3 d were lower than those in the propofol group, and the differences were not statistically significant. The POCD incidence in sevoflurane group was higher than that in propofol group 3 h and 6 h after surgery, and the difference was statistically significant (P<0.05). Conclusions: Neither sevoflurane nor propofol can affect the postoperative recovery of elderly patients, but both can affect the cognitive function of patients to some extent. The effect of propofol on the early postoperative cognitive function of patients is slightly lower than that of sevoflurane.

关 键 词：七氟醚 异丙酚 老年 苏醒 认知功能 

分 类 号：R614[医药卫生—麻醉学]