七氟醚对老年手术患者术后认知功能及血清神经元特异性烯醇化酶的影响  

Effect of Sevoflurane on Postoperative Cognitive Function and Expression of Serum Neuron-specific Enolase in Elderly Patients Undergoing Surgery

作　　者：李庆忠[1] LI Qingzhong(Jinan Third People’s Hospital,Jinan 250132,China)

机构地区：[1]济南市第三人民医院,山东济南250132

出　　处：《中国医学创新》2022年第22期59-63,共5页Medical Innovation of China

摘　　要：目的:探讨七氟醚对老年手术患者术后认知功能及血清神经元特异性烯醇化酶(NSE)的影响。方法:选择2019年9月-2021年6月在济南市第三人民医院行腹部手术的60例老年患者为研究对象。根据随机数字表法分为对照组和观察组,每组30例。两组患者均给予相同的麻醉诱导,对照组患者给予丙泊酚麻醉维持,观察组患者给予七氟醚麻醉维持。比较两组患者术后苏醒时间、呼吸恢复时间、吞咽反射恢复时间及拔管时间;比较两组患者术后1、3 d认知功能障碍(POCD)发生率;比较两组患者术前和术后1、3 d认知功能;比较两组患者术前和术后1、3 d NSE水平;比较两组患者不良反应发生率。结果:观察组患者苏醒时间、呼吸恢复时间、吞咽反射恢复时间及拔管时间均早于对照组(P<0.05);术后1 d观察组患者POCD发生率低于对照组,差异有统计学意义(P<0.05),术后3 d两组POCD发生率比较,差异无统计学意义(P>0.05);两组术前MMSE评分结果比较,差异无统计学意义(P>0.05),术后1 d对照组患者和观察组患者的MMSE评分均低于术前(P<0.05),对照组患者术后3 d MMSE评分低于术前(P<0.05),但高于术后1 d(P<0.05),观察组患者术后3 d MMSE评分与术前比较,差异无统计学意义(P>0.05),但高于术后1 d(P<0.05),观察组术后1、3 d的MMSE评分均高于对照组同期(P<0.05);对照组和观察组患者术前NSE水平比较,差异无统计学意义(P>0.05),术后1、3 d两组患者的NSE水平均高于术前(P<0.05),但两组患者术后3 d的NSE水平均低于术后1 d(P<0.05),观察组术后1、3 d的NSE水平均低于对照组患者术后同期(P<0.05)。两组间不良反应发生率比较,差异无统计学意义(P>0.05)。结论:七氟醚对老年手术患者术后认知功能的负面影响小于丙泊酚,患者术后认知功能障碍发生率相对较低,且术后血清神经元特异性烯醇化酶水平低于丙泊酚,脑损伤相对较轻,神经修复更快。Objective:To investigate the effect of Sevoflurane on postoperative cognitive function and expression of serum neuron-specific enolase (NSE) in elderly patients.Method:A total of 60 elderly patients who underwent abdominal surgery in Jinan Third People’s Hospital from September 2019 to June 2021 were selected as the research objects.According to the method of random number table,they were divided into control group and observation group,with 30 cases in each group.The patients in both groups were given the same anesthesia induction,the patients in the control group were given Propofol anesthesia maintenance,and the patients in the observation group were given Sevoflurane anesthesia maintenance.The postoperative recovery time,respiratory recovery time,swallowing reflex recovery time and extubation time were compared between the two groups.The incidences of cognitive impairment (POCD) 1,3 d after operation were compared between the two groups.The cognitive function before operation and 1,3 d after operation were compared between the two groups.The levels of serum NSE were compared before operation and 1,3 d after operation.The incidence of adverse reactions was compared between the two groups.Result:The recovery time,respiratory recovery time,swallowing reflex recovery time and extubation time in the observation group were earlier than those in the control group (P0.05).There was no significant difference in the MMSE score before operation between the control group and the observation group (P>0.05).The MMSE score in the control group and the observation group on the 1 d after operation were lower than those before operation (P0.05),but higher than that 1 d after operation (P0.05).The levels of NSE in the two groups on the 1,3 d after operation were higher than those before operation (P0.05).Conclusion:Sevoflurane has less negative effect on postoperative cognitive function in elderly patients than Propofol,and the incidence of postoperative cognitive dysfunction is relatively low,and the level of neuron-specific

关 键 词：七氟醚 丙泊酚 老年 认知功能 

分 类 号：R614[医药卫生—麻醉学]