双氯芬酸钠栓对腹腔镜胆囊切除术老年患者围手术期认知功能的影响  

Effect of diclofenac sodium suppository on perioperative cognitive function in elderly patients undergoing laparoscopic cholecystectomy

作　　者：胡博[1] 成广海[1] HU Bo;CHENG Guanghai(Xi'an Aerospace General Hospital,Xi'an 710100,China)

机构地区：[1]西安航天总医院,陕西西安710100

出　　处：《临床医学研究与实践》2020年第32期40-42,共3页Clinical Research and Practice

基　　金：西安市卫生健康委员会科研项目(No.2020yb82)。

摘　　要：目的探讨双氯芬酸钠栓对腹腔镜胆囊切除术老年患者围手术期认知功能的影响。方法将我院普外科行腹腔镜胆囊切除术的80例老年胆囊结石患者按照随机数字表法分为对照组和观察组,每组40例。对照组术中采用丙泊酚持续靶控静脉输注麻醉,观察组在对照组基础上加用双氯芬酸钠栓剂。比较两组的麻醉效果优良率、生命体征指标、术后意识苏醒时间、拔管时间、血清炎症因子指标水平及认知功能评分。结果两组的麻醉效果优良率无显著差异(P>0.05)。气管插管前及气管插管后5、10 min,两组的收缩压、舒张压、心率组内和组间均无显著差异(P>0.05)。观察组术后的自主呼吸恢复时间、睁眼时间、指令恢复时间、拔管时间均短于对照组(P<0.05)。气管插管后,观察组的血清IL-6水平低于对照组,血清IL-10水平高于对照组(P<0.05)。手术后,观察组的MoCA、MMSE评分均高于对照组,差异具有统计学意义(P<0.05)。结论双氯芬酸钠栓应用于老年腹腔镜胆囊切除术患者中,可维持生命体征平稳,加快术后意识苏醒,减轻炎症反应,有利于减轻术后认知功能障碍。Objective To investigate the effect of diclofenac sodium suppository on perioperative cognitive function in elderly patients undergoing laparoscopic cholecystectomy.Methods Eighty elderly patients with gallstone underwent laparoscopic cholecystectomy in the general surgery department of our hospital were divided into control group and observation group according to the random number table method,with 40 cases in each group.The control group was anesthetized by continuous target controlled intravenous infusion of propofol,while the observation group was given diclofenac sodium suppository on the basis of the control group.The excellent and good rate of anesthesia effect,vital signs indexes,postoperative consciousness recovery time,extubation time,serum inflammatory factors indexes levels and cognitive function scores were compared between the two groups.Results There was no significant difference in excellent and good rate of anesthesia effect between the two groups(P>0.05).There were no significant differences in systolic blood pressure,diastolic blood pressure and heart rate within groups and between the two groups before tracheal intubation and at 5,10 min after tracheal intubation(P>0.05).The recovery time of spontaneous breathing,eye opening time,command recovery time and extubation time in the observation group were shorter than those in the control group(P<0.05).After tracheal intubation,the serum IL-6 level of the observation group was lower than that of the control group,and the serum IL-10 level was higher than that of the control group(P<0.05).After operation,MoCA and MMSE scores of the observation group were higher than those of the control group,the differences were statistically significant(P<0.05).Conclusion The diclofenac sodium suppository applied in elderly patients with laparoscopic cholecystectomy can maintain stable vital signs,accelerate postoperative consciousness recovery,and reduce inflammatory reaction,which is beneficial to reduce postoperative cognitive dysfunction.

关 键 词：腹腔镜胆囊切除术 丙泊酚 双氯芬酸钠栓 认知功能 

分 类 号：R614[医药卫生—麻醉学]