ERAS理念联合预防性麻醉管理在老年胸外科手术患者中的应用及对预后的影响  

Application of ERAS Concept Combined with Preventive Anesthesia Management for Elderly Patients with Thoracic Surgery and Prognosis Effect

作　　者：莫桂熙 MO Guixi(Guangzhou Medical University Affiliated Hospital,Guangzhou,Guangdong 510150)

机构地区：[1]广州医科大学附属医院,广东广州510150

出　　处：《智慧健康》2023年第16期258-261,共4页Smart Healthcare

摘　　要：目的探讨和评价分析加速康复外科(enhanced recovery after surgery,ERAS)理念联合预防性麻醉管理在老年胸外科手术患者中的应用情况及对预后的影响。方法选取2021年3月-2022年8月本院收治的240例老年胸外科手术患者进行研究,根据组间基本特征具有可比性的原则将研究对象分为干预组和对照组,每组各120例,两组患者均采取椎旁神经阻滞复合全麻,对照组实施常规麻醉管理,干预组在此基础上实施ERAS理念联合预防性麻醉管理,记录两组患者手术相关指标,并比较分析患者术后指标(IL-6、CRP和Cor水平),运用MMSE评分量表对两组患者术前1d、术后12h及24 h的认知功能进行评估。结果干预组患者手术中相关指标的时间均短于对照组,差异具有统计学意义(P<0.05);干预组患者术后24h的血清指标IL-6、CRP和Cor水平明显低于对照组;与术前相比,术后12h及24h对照组患者MMSE评分均下降,差异具有统计学意义(P<0.05),术后12h及24h干预组患者MMSE评分并未发生明显改变,差异没有统计学意义(P>0.05);与对照组相比,术后12h、术后24h干预组患者MMSE评分明显高于对照组,差异具有统计学意义(P<0.05)。结论ERAS理念联合预防性麻醉管理能够缩短老年胸外科手术患者术后恢复时间,保护认知功能,值得推广使用。Objective To explore and evaluate application of concept of enhanced recovery after surgery(ERAS)combined with preventive anesthesia management for elderly patients with thoracic surgery and prognosis effect.Methods The paper chose 240 elderly patients with thoracic surgery in our hospital from March 2021 to August 2022 for study,and divided them into intervention group and control group according to principle of comparability of basic characteristics,with 120 cases in each group,(P<0.05).Both groups was treated with paravertebral nerve block combined with general anesthesia,control group with routine anesthesia management,intervention group with ERAS concept combined with preventive anesthesia management on the basis of control group.Relevant indicators of patients in both groups were recorded,postoperative indicators(IL-6,CRP and Cor levels)of patients were compared and analyzed,cognitive function was evaluated with MMSE scoring scale between two groups 1 day before surgery,12 hours and 24 hours after surgery.Results Duration of relevant indicators during surgery in intervention group was shorter than control group,difference was statistically significant(P<0.05).Serum levels of IL-6,CRP and Cor in intervention group were significantly lower than control group 24 hours after surgery.MMSE scores of control group were lower at 12 hours and 24 hours after surgery than before surgery,difference was statistically significant(P<0.05).MMSE scores of intervention group showed no significant changes at 12 hours and 24 hours after surgery,difference was not statistically significant(P>0.05).MMSE scores in intervention group at 12 hours and 24 hours after surgery were significantly higher than control group,difference was statistically significant(P<0.05).Conclusion ERAS concept combined with preventive anesthesia management can shorten postoperative recovery time,protect cognitive function of elderly patients with thoracic surgery,which is worthy of promotion.

关 键 词：ERAS理念 麻醉管理 胸外科手术 认知功能 

分 类 号：R614[医药卫生—麻醉学]