靶控输注丙泊酚与七氟烷吸入麻醉对老年肿瘤患者认知功能影响的对比研究  

Comparative Study on the Influence of Target-Controlled Infusion of Propofol and Inhalation of Sevoflurane on Cognitive Function in Elderly Patients with Cancer

作　　者：孙玥[1] 翟希[2] 孙晓峰[1] SUN Yue;ZHAI Xi;SUN Xiaofeng(Dept.of Anesthesiology,Shenyang Medical College Affiliated Central Hospital,Liaoning Shenyang 110024,China;Dept.of Hand Surgery,Shenyang Medical College Affiliated Central Hospital,Liaoning Shenyang 110024,China)

机构地区：[1]沈阳医学院附属中心医院麻醉科,辽宁沈阳110024 [2]沈阳医学院附属中心医院手外科,辽宁沈阳110024

出　　处：《中国医院用药评价与分析》2019年第11期1363-1365,共3页Evaluation and Analysis of Drug-use in Hospitals of China

摘　　要：目的:探讨靶控输注丙泊酚与七氟烷吸入麻醉对老年肿瘤患者认知功能的影响。方法:选取2017年1月至2018年11月沈阳医学院附属中心医院收治的老年肿瘤患者106例,采用随机数字表法分为观察组50例与对照组56例。两组患者常规建立静脉通道、行麻醉诱导,气管插管后,连接麻醉机行机械通气;观察组患者给予靶控输注丙泊酚维持麻醉,对照组患者给予吸入七氟烷维持麻醉。采用简易精神状态检查量表(mini mental status examination,MMSE)评价两组患者麻醉前后的认知功能;监测两组患者麻醉前后血清S100β蛋白水平;比较两组患者麻醉前和术后24 h血清丙二醛水平的差异,观察两组患者的麻醉苏醒时间、拔管时间和应答时间。结果:麻醉后,两组患者的MMSE评分均明显降低;麻醉后1、4及6 h,观察组患者的MMSE评分明显高于对照组,差异有统计学意义(P<0.05);麻醉后6 h,观察组患者的MMSE评分已恢复至麻醉前水平,而对照组患者则在麻醉后12 h才恢复至麻醉前水平;麻醉后12 h,两组患者MMSE评分的差异无统计学意义(P>0.05)。麻醉后0.5 h,两组患者S100β蛋白水平均明显升高,组间比较的差异无统计学意义(P>0.05);麻醉后48 h,观察组患者的S100β水平恢复至麻醉前水平,但对照组患者仍维持在较高水平,组间比较的差异有统计学意义(P<0.05)。术后24 h,观察组患者平均丙二醛水平为(6.50±0.72)nmol/L,明显低于对照组的(12.55±1.38)nmol/L,差异均有统计学意义(P<0.05)。观察组患者的麻醉苏醒时间、拔管时间和应答时间均明显短于对照组,差异均有统计学意义(P<0.05)。结论:靶控输注丙泊酚能有效缩短患者麻醉后认知功能障碍时间,使MMSE评分和S100β水平更早恢复至麻醉前水平,患者更早苏醒、拔管和应答,麻醉效果满意。OBJECTIVE: To investigate the effects of target-controlled infusion of propofol and inhalation of sevoflurane on cognitive function in elderly patients with cancer. METHODS: Totally 106 elderly patients with cancer admitted into Shenyang Medical College Affiliated Central Hospital from Jan. 2017 to Nov. 2018 were extracted to be divided into the observation group(n=50) and the control group(n=56) via the random number table. Venous pathway was established routinely for both groups, after anesthesia induction and intubation, all patients were mechanically ventilated through anesthesia machine. Patients in the observation group were given target-controlled infusion of propofol to maintain anesthesia, while the control group received inhalation of sevoflurane to maintain anesthesia. The Mini-Mental State Examination(MMSE) was used to evaluate the cognitive function of two groups before and after anesthesia. The levels of S100β protein in two groups were monitored before and after anesthesia. Differences of serum levels of malondialdehyde were compared between two groups before and 24 h after anesthesia. The recovery time, extubation time and response time of anesthesia of two groups were recorded. RESULTS: After anesthesia, the MMSE score of both groups decreased significantly. After anesthesia of 1, 4 and 6 h, the MMSE score of the observation group were significantly higher than those of the control group, and the difference was statistically significant(P<0.05). After anesthesia of 6 h, the MMSE score in the observation group returned to pre-anesthesia levels, while the control group achieved the recovery level after anesthesia of 12 h. After anesthesia of 12 h, there was no significant difference in MMSE score between two groups(P>0.05). After anesthesia of 0.5 h, the levels of S100β protein in two groups increased significantly, yet there was no significant difference between two groups(P>0.05). After anesthesia of 48 h, the levels of S100β in the observation group returned to pre-anesthesia levels, but the

关 键 词：靶控输注 丙泊酚 七氟烷 认知功能 

分 类 号：R971[医药卫生—药品]