七氟烷联合异丙酚麻醉对行腹腔镜胆囊切除术患者应激反应及认知功能的影响  

Effects of sevoflurane combined with propofol on stress response and cognitive function in patients undergoing laparoscopic cholecystectomy

作　　者：詹文华 冯昕 Zhan Wenhua;Feng Xin(The First People's Hospital of Jiujiang City,Jiujiang,Jiangxi 332005,China;Jiujiang Hospital of Traditional Chinese Medicine,Jiujiang,Jiangxi 332099,China)

机构地区：[1]江西省九江市第一人民医院,江西九江332005 [2]江西省九江市中医医院,江西九江332099

出　　处：《首都食品与医药》2024年第9期63-65,共3页Capital Food Medicine

摘　　要：目的探讨七氟烷联合异丙酚麻醉对行腹腔镜胆囊切除术(LC)患者应激反应及认知功能的影响.方法选择2021年1月-2023年7月在九江市第一人民医院拟行LC治疗的84例患者,按随机数字表法分为联合组与单一组,每组各42例.单一组使用异丙酚麻醉,联合组使用七氟烷联合异丙酚麻醉.对比两组苏醒质量、应激反应、认知功能及躁动、不良反应.结果联合组睁眼时间、自主呼吸恢复时间、拔管时间及语言应答时间较单一组短(P<0.05);术后两组肾上腺皮质激素(ACTH)检测值均高于术前,一氧化氮(NO)检测值与简易精神状态检查量表(MMSE)评分均低于术前,但联合组ACTH、NO检测值低于单一组,MMSE评分较单一组高(P<0.05);联合组躁动发生率较单一组低(P<0.05);两组不良反应对比,无统计学差异(P>0.05).结论七氟烷联合异丙酚麻醉应用于LC术中可减轻应激反应及对认知功能造成的损伤,减少躁动发生,改善苏醒质量,安全性较高.Objective To investigate the effects of sevoflurane combined with propofol anesthesia on stress response and cognitive function in patients undergoing laparoscopic cholecystectomy(LC).Methods A total of 84 patients who were to receive LC treatment in Jiujiang First People's Hospital from January 2021 to July 2023 were selected and divided into combined group and single group according to random number table method,with 42 cases in each group.The single group was anesthetized with propofol,and the combined group was anesthetized with sevoflurane and propofol.The quality of awakening,stress response,cognitive function,agitation and adverse reactions were compared between the two groups.Results The eye opening time,spontaneous breathing recovery time,extubation time and language response time of combined group were shorter than those of single group(P<0.05).After operation,the adrenocortical hormone(ACTH)detection value in two groups was higher than before operation,the nitric oxide(NO)detection value and the score of MMSE were lower than before operation,but the ACTH and NO detection value in combination group was lower than that in single group,and the MMSE score was higher than that in single group(P<0.05).The incidence of agitation in combined group was lower than that in single group(P<0.05).There was no significant difference in adverse reactions between the two groups(P>0.05).Conclusion Sevoflurane combined with propofol can reduce the stress response and the damage to cognitive function,reduce the occurrence of agitation,improve the quality of recovery,and have high safety.

关 键 词：腹腔镜胆囊切除术 七氟烷 应激反应 异丙酚 认知功能 麻醉 

分 类 号：R614[医药卫生—麻醉学]