电针复合药物全麻对老年腹腔镜胆囊切除术患者血流动力学和认知功能的影响  

Effect of Electroacupuncture Compound General Anesthesia on Hemodynamics and Cognitive Function of Senile Patients after Laparoscopic Cholecystectomy

作　　者：魏青 高特生[1] 王寿根[1] 黄月伟 WEI Qing;GAO Tesheng;WANG Shougen;HUANG Yuewei

机构地区：[1]嘉兴市中医医院麻醉科,浙江嘉兴314000

出　　处：《新中医》2020年第9期120-123,共4页New Chinese Medicine

摘　　要：目的:探讨电针复合药物全麻对老年腹腔镜胆囊切除术患者血流动力学、认知功能的影响。方法:选取行腹腔镜胆囊切除术治疗的患者134例,按随机数字表法分为观察组和对照组各67例。对照组给予静脉复合全麻,观察组给予静脉复合全麻加电针全麻。比较2组患者血流动力学指标及认知功能。结果:麻醉诱导前,2组心率(HR)、收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)比较,差异无统计学意义(P>0.05)。观察组充气后5 min、胆囊切除以及术毕时,HR、SBP、DBP、MAP与麻醉诱导前相比,差异无统计学意义(P>0.05);对照组HR、SBP、DBP、MAP在充气后5 min、术毕均较麻醉诱导前显著升高,而SBP、DBP、MAP在胆囊切除时明显降低(P<0.05)。充气后5 min,观察组HR、SBP、DBP、MAP的波动幅度显著低于对照组(P<0.05)。术后第3天,观察组肾上腺素(E)、去甲肾上腺素(NE)、皮质醇(Cor)水平均低于对照组,差异均有统计学意义(P<0.05)。术毕,2组S-100β蛋白、神经元特异性烯醇酶(NSE)均较麻醉诱导前升高,且对照组升高幅度更明显(P<0.05);但在术后第3天,2组S-100β蛋白、NSE均恢复正常水平(P>0.05)。术后,2组定向力、瞬时记忆、注意力、短时记忆、语言能力、视空间觉评分均较术前降低,但观察组术后以上评分降低幅度均低于对照组(P<0.05)。结论:电针复合药物全麻在老年腹腔镜胆囊切除术中应用较佳,可降低血流动力学指标的波动及应激水平,减少对认知功能的损伤,较为安全,值得在临床上推广应用。Objective:To discuss the effect of electroacupuncture compound general anesthesia on hemodynamics and cognitive function of senile patients after laparoscopic cholecystectomy.Methods:A total of 134 cases of patients undergone laparoscopic cholecystectomy were divided into the observation group and the control group according to the random number table method,67 cases in each group.The control group was given intravenous balanced general anesthesia,and the observation group was given electroacupuncture compound general anesthesia.The homological indexes and cognitive function were compared between the two groups.Results:Before anesthesia induction,when compared heart rate(HR),systolic blood pressure(SBP),diastolic blood pressure(DBP)and mean arterial pressure(MAP)between the two groups,there was no significance in the difference(P>0.05).In the observation group,when compared the HR,SBP,DBP and MAP at the 5 thminute after inhalation,during cholecystectomy and after surgery with those before anesthesia induction respectively,there was no significance in the difference(P>0.05).In the control group,the HR,SBP,DBP and MAP at the 5 thminute after inhalation and after surgery were significantly increased when compared with those before anesthesia induction respectively,and the SBP,DBP and MAP during cholecystectomy were significantly decreased(P<0.05).At the 5 thminute after inhalation,the fluctuation range of HR,SBP,DBP and MAP in the observation group was significantly smaller than that in the control group(P<0.05).On the 3 rdday after surgery,the levels of epinephrine(E),norepinephrine(NE)and cortisol(Cor)in the observation group were lower than those in the control group,differences being significant(P<0.05).After surgery,the levels of S-100βprotein and neuron specific enolase(NSE)in the two groups were increased when compared with those before anesthesia induction,and the increase in the control group was more significant(P<0.05);but,on the 3 rdday after surgery,the levels of S-100βprotein and NSE in the two group

关 键 词：腹腔镜胆囊切除术 老年 电针 药物全麻 血流动力学 认知功能 

分 类 号：R614[医药卫生—麻醉学] R657.4[医药卫生—外科学]