两种全身麻醉方式对腹腔镜全子宫切除术老年患者术后认知功能的影响  

作　　者：高丽君[1] 沈虹春[1] 陈熔杰 

机构地区：[1]浙江省慈溪市妇幼保健院,315300

出　　处：《浙江临床医学》2024年第3期428-430,共3页Zhejiang Clinical Medical Journal

基　　金：宁波市医学科技计划项目(2019Y69)。

摘　　要：目的 分析两种全身麻醉方式对腹腔镜全子宫切除术老年患者术后认知功能的影响。方法 选取2020年4月至2022年12月腹腔镜手术老年患者80例,分为丙泊酚组40例,七氟烷组40例。丙泊酚组术中靶控输注丙泊酚,七氟烷组术中持续吸入七氟烷。比较两组麻醉诱导前、术后6 h、术后1 d、术后3 d认知功能及T0、T1、T2、T3、T4时平均动脉压(MAP)、心率(HR)、脉搏血氧饱和度(SpO_(2))、呼气末二氧化碳分压(PetCO_(2)),统计两组患者术后恢复情况、术后认知功能障碍。结 果麻醉诱导前两组简易智力状态检查(MMSE)评分差异无统计学意义(P>0.05)。术后6 h、术后1 d、术后3 d时MMSE评分均下降,但七氟烷组MMSE评分高于丙泊酚组(P<0.05)。T1、T2、T3、T4时MAP、HR水平均下降,但七氟烷组MAP、HR水平高于丙泊酚组,T1、T2、T3、T4时PetCO_(2)水平均升高,但七氟烷组PetCO_(2)水平低于丙泊酚组(P<0.05)。七氟烷组PACU留时间、拔管时间明显短于丙泊酚组,术后3 d视觉模拟评分(VAS)、术后认知功能障碍发生率低于丙泊酚组(P<0.05)。结论 腹腔镜全子宫切除术老年患者应用七氟烷进行全身麻醉,患者生命体征影响较小,且术后认知功能障碍发生率较低。Objective To analyze the effect of two general anesthesia methods on postoperative cognitive function of elderly patients undergoing total laparoscopic hysterectomy.Methods A total of 80 elderly patients with laparoscopic surgery who were diagnosed and treated in our hospital from April 2020 to December 2022 were selected as the research objects,and they were divided into the propofol group with 40 cases and the sevoflurane group with 40 cases.The propofol group received intraoperative target-controlled infusion of propofol,and the sevoflurane group received continuous inhalation of sevoflurane during the operation.The cognitive function before anesthesia induction,6 hours after operation,1 day after operation,and 3 days after operation,mean arterial pressure(MAP),heart rate(HR),oxygen saturation(SpO_(2)),end-tidal carbon dioxide partial pressure(PetCO_(2))at T0,T1,T2,T3,and T4 of the two groups were detected and compared.Postoperative recovery and postoperative cognitive dysfunction of the two groups were calculated.Results Before anesthesia induction,the mini-mental state examination(MMSE)scores of the two groups were compared(P>0.05),the MMSE scores decreased at 6 h,1 d,and 3 d after surgery,but the MMSE score in the sevoflurane group was higher than that in the propofol group(P<0.05).The levels of MAP and HR were decreased at T1,T2,T3,and T4,but the levels of MAP and HR in the sevoflurane group were higher than those in the propofol group,and the levels of PetCO2 increased at T1,T2,T3,and T4,but the levels of PetCO_(2) in the sevoflurane group were lower than those in the propofol group(P<0.05).The post-anesthesia care unit(PACU)retention time and extubation time in the sevoflurane group were significantly shorter than those in the propofol group,and the postoperative 3-day visual analogue scale(VAS)score and the incidence of postoperative cognitive dysfunction were lower than those in the propofol group(P<0.05).Conclusion In elderly patients undergoing total laparoscopic hysterectomy,intraoperative general a

关 键 词：腹腔镜 认知功能 丙泊酚 七氟烷 

分 类 号：R614[医药卫生—麻醉学]