意识指数和脑电双频指数监测不同麻醉深度对肠癌患者术后认知障碍的影响比较  

Comparison of IoC and EEG Dual-frequency Index Monitoring of Different Anesthesia Depth on Postoperative Cognitive Impairment in Patients with Bowel Cancer

作　　者：康振明[1] 陈如霜[1] 苏长生 李顺元[1] 谢文钦[1] KANG Zhenming;CHEN Rushuang;SU Changsheng;LI Shunyuan;XIE Wenqin(Quanzhou First Hospital Affiliated to Fujian Medical University,Quanzhou 362000,China)

机构地区：[1]福建医科大学附属泉州第一医院,福建泉州362000

出　　处：《中外医学研究》2020年第33期32-34,共3页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：福建医科大学启航基金项目(2017XQ1173);泉州市科技计划项目(2018N056S)。

摘　　要：目的:旨在探讨与了解意识指数(IoC)和脑电双频指数(BIS)监测不同麻醉深度对肠癌患者术后认知功能障碍的影响。方法:选取笔者所在医院2017年6月-2019年6月院收治的肠癌患者120例,按随机数字表法分为IoC组、BIS组及对照组,分别是采用IoC监测、BIS监测,对照组则是根据临床经验实施常规麻醉,每组40例。观察三组丙泊酚用药量、清醒时间及拔管时间,并采用简易精神状态量表(MMSE)对患者术前24 h,术后24 h、3 d、7 d的认知功能障碍发生情况进行评分。结果:IoC组、BIS组的丙泊酚用量与对照组相比减少,差异有统计学意义(P<0.05);IoC组降低丙泊酚用量在三组中最明显。IoC组、BIS组的清醒时间及拔管时间相比于对照组缩短,组间差异有统计学意义(P<0.05)。与术前24 h相比,各组术后24 h和术后3 d患者MMSE评分均表现降低,其中对照组下降最为明显(P<0.05)。IoC组和BIS组肠癌患者出现认知功能障碍的概率显著低于对照组(P<0.05),并且IoC组、BIS组肠癌患者手术后出现不良反应情况明显少于对照组(P<0.05)。结论:麻醉过程中采用意识指数和脑电双频指数监测,显著提高了麻醉镇静深度判断的准确性,有效降低老年患者术后认知功能障碍的发生。Objective:To explore and understand the effect of consciousness index(IoC)and EEG dual-frequency index(BIS)monitoring of different anesthesia depth on postoperative cognitive dysfunction in patients with bowel cancer.Method:A total of 120 patients with intestinal cancer admitted to our hospital from June 2017 to June 2019 were selected and divided into IoC group,BIS group and control group according to random number table method,40 cases in each group.IoC monitoring,BIS monitoring were adopted respectively.According to clinical experience,routine anesthesia was performed in control group.Observe the three groups of propofol dosage,waking time and extubation time,and use the simple mental state scale(MMSE)to understand the patients'occurrence of dysfunction 24 hours before operation,24 hours after operation,3 days after operation,and 7 days after operation.Result:The amount of propofol in the IoC group and the BIS group decreased compared with the control group,the difference was statistically significant(P<0.05).The reduction in the amount of propofol in the IoC group was the most obvious among the three groups.Waking time and extubation time were shortened compared with the control group,and the difference between control group and IoC,BIS the groups was statistically significant(P<0.05).Compared with 24 h before surgery,the MMSE scores of patients in each group after 24 h and 3 d after surgery decreased,of which the control group decreased more significantly(P<0.05).The probability of cognitive dysfunction in bowel cancer patients in IoC group and BIS group was significantly lower than that in control group(P<0.05),and the adverse reaction of bowel cancer patients in IoC group and BIS group after surgery was significantly less than that in control group(P<0.05).Conclusion:Monitoring the consciousness index and EEG dual-frequency index during anesthesia significantly improves the accuracy of anesthesia sedation depth judgment and effectively reduces the occurrence of postoperative cognitive dysfunction in elderl

关 键 词：意识指数 脑电双频指数 麻醉深度 肠癌 术后认知功能障碍 

分 类 号：R614[医药卫生—麻醉学] R735.3[医药卫生—外科学]