丙泊酚复合瑞芬太尼对老年腹腔镜胆囊切除术患者应激反应及认知功能的影响  

Effects of Propofol Combined with Remifentanil on Stress Response and Cognitive Function in Elderly Laparoscopic Cholecystectomy Patients

作　　者：王艳 吴若秋 陆阳海 WANG Yan;WU Ruoqiu;LU Yanghai(Operating room,Bijie Hospital of Traditional Chinese Medicine,Bijie,Guizhou Province,551700 China)

机构地区：[1]毕节市中医医院手术室,贵州毕节551700

出　　处：《系统医学》2024年第3期80-83,共4页Systems Medicine

摘　　要：目的探讨丙泊酚复合瑞芬太尼对老年腹腔镜胆囊切除术患者的影响。方法选取2020年7月—2023年2月于毕节市中医院行腹腔镜胆囊切除术的老年患者76例为研究对象,按照随机数表法分为两组,各38例。对照组采取丙泊酚复合舒芬太尼,观察组采取丙泊酚复合瑞芬太尼。比较两组患者应激反应、认知功能与术后不良反应。结果两组麻醉诱导前与气管插管前的应激反应、麻醉诱导前的认知功能比较,差异无统计学意义(P均>0.05);观察组气管插管后皮质醇[(387.68±12.79)μg/L]、手术完成后皮质醇[(395.15±14.06)μg/L]、气管插管后肾上腺素[(84.05±5.44)ng/L]、手术完成后肾上腺素[(92.46±6.75)ng/L],低于对照组的(403.23±15.69)μg/L、(413.54±16.83)μg/L、(98.65±6.49)ng/L、(107.84±8.22)ng/L,差异有统计学意义(t=4.735、5.169、10.628、8.914,P均<0.05);观察组拔管后简易精神状态量表(Mini-Mental State Examination,MMSE)评分[(24.37±1.28)分]、手术完成后MMSE评分[(25.69±1.85)分],高于对照组的(23.55±1.04)分、(24.71±1.41)分,差异有统计学意义(t=3.065、2.597,P均<0.05);两组术后不良反应发生率比较,差异无统计学意义(P>0.05)。结论相较于丙泊酚复合舒芬太尼麻醉,腹腔镜胆囊切除术老年患者采取丙泊酚复合瑞芬太尼的麻醉效果更好,且患者应激反应更小,安全性高。Objective To explore the effects of propofol compound remifentanil on elderly laparoscopic cholecystec⁃tomy patients.Methods 76 cases of elderly patients who underwent laparoscopic cholecystectomy in Bijie Hospital of Traditional Chinese Medicine from July 2020 to February 2023 were selected as the study objects and divided into 2 groups of 38 cases each according to the randomized numerical table method.The control group took propofol com⁃pound sufentanil,and the observation group took propofol compound remifentanil.Stress reaction,cognitive function and postoperative adverse reactions were compared between the two groups of patients.Results There was no statisti⁃cally significance difference in stress reaction and cognitive function before induction of anesthesia and tracheal intuba⁃tion in the two groups(all P>0.05).In the observation group,post-tracheal intubation cortisol[(387.68±12.79)μg/L],post-surgical completion cortisol[(395.15±14.06)μg/L],post-tracheal intubation epinephrine[(84.05±5.44)ng/L],and post-surgical completion adrenaline[(92.46±6.75)ng/L]were lower than those in the control group[(403.23±15.69)μg/L],[(413.54±16.83)μg/L],[(98.65±6.49)ng/L],and[(107.84±8.22)ng/L]in the control group,and the dif⁃ferences were statistically significant(t=4.735,5.169,10.628,8.914,all P<0.05).In the observation group,the scores of Mini-mental State Examination(MMSE)after extubation[(24.37±1.28)points]and after completion of surgery(25.69±1.85)points were higher than those of the control group[(23.55±1.04)points],[(24.71±1.41)points],and the differences were statistically significant(t=3.065,2.597,both P<0.05).There was no statistically significance differ⁃ence in postoperative adverse reactions between the two groups(P>0.05).Conclusion Compared with propofol com⁃pound sufentanil anesthesia,laparoscopic cholecystectomy for elderly patients to take propofol compound remifentanil anesthesia effect is better,and the patient's stress reaction is smaller,and the safety is high.

关 键 词：腹腔镜胆囊切除术 丙泊酚 瑞芬太尼 应激反应 认知功能 

分 类 号：R4[医药卫生—临床医学]