不同麻醉方法对直肠癌根治术老年患者术后睡眠质量影响探讨  

Influence of Different Anesthesia Methods on Postoperative Sleep Quality in Elderly Patients with Radical Rectal Cancer Surgery

作　　者：肖少文 阳艳晖 张华 郭倩玲 周阳永 李金连 XIAO Shaowen;YANG Yanhui;ZHANG Hua;GUO Qianling;ZHOU Yangyong;LI Jinlian(Department of Anesthesiology,Nansha District People's Hospital,Guangzhou,Guangdong,511470,China;Department of Nursing,Nansha District People's Hospital,Guangzhou,Guangdong,511470,China;Department of Anesthesiology,the 922nd Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army,Hengyang,Hunan,421002,China)

机构地区：[1]广州市南沙区人民医院麻醉科,广东广州511470 [2]广州市南沙区人民医院护理部,广东广州511470 [3]中国人民解放军联勤保障部队第九二二医院麻醉科,湖南衡阳421002

出　　处：《中外医疗》2024年第27期13-17,共5页China & Foreign Medical Treatment

摘　　要：目的分析不同麻醉方法对直肠癌根治术老年患者术后睡眠质量的影响。方法方便选取2023年2月—2024年6月广州市南沙区人民医院收治的98例进行直肠癌根治术的老年患者为研究对象,根据不同的麻醉方式分为对照组(全身麻醉)和观察组(硬膜外阻滞复合全身麻醉),各49例。分析两组患者的血流动力学指标、术后恢复情况、疼痛、认知功能和睡眠质量评分。结果诱导前5 min时,两组患者的心率(heart rate,HR)、平均动脉压(mean arterial pressure,MAP)比较,差异无统计学意义(P均>0.05)。插管后5 min和手术结束时,观察组患者的HR和MAP均低于对照组,差异有统计学意义(P均<0.05)。观察组的睁眼时间、自主呼吸恢复时间、言语应答时间和拔管时间均短于对照组,差异有统计学意义(P均<0.05)。观察组术后6 h、术后24 h、术后48 h的疼痛评分均低于对照组,差异有统计学意义(P均<0.05)。观察组的术后1 d、3 d、7 d认知功能评分均高于对照组,差异有统计学意义(P均<0.05)。观察组术后24 h、术后2 d、术后5 d和术后10 d的睡眠质量评分为(13.64±2.19)分、(9.73±1.55)分、(6.74±1.26)分、(4.57±0.27)分,均低于对照组的(15.86±2.45)分、(11.29±1.73)分、(8.21±1.43)分、(6.31±0.57)分,差异有统计学意义(t=4.729、4.701、5.399、19.311,P均<0.05)。结论与全身麻醉相比,硬膜外阻滞复合全身麻醉可以有效改善患者术后恢复情况,且对术中的血流动力学指标影响较小,能进一步改善患者术后疼痛、认知功能及睡眠情况。Objective To analyze the influence of different anesthesia methods on sleep quality of elderly patients after radical resection of rectal cancer.Methods Ninety-eight elderly patients undergoing radical resection of rectal cancer treated in Nansha District People's Hospital of Guangzhou from February 2023 to June 2024 were conveniently selected as the study objects.According to different anesthesia methods,they were divided into control group(general anesthesia)and observation group(epidural block combined general anesthesia),with 49 cases in each group.The hemodynamic indexes,postoperative recovery,pain,cognitive function and sleep quality scores of the two groups were analyzed.Results At 5 min before induction,there were no significant difference between the two groups in heart rate(HR)and mean arterial pressure(MAP)(all P>0.05).At 5 min after intubation and at the end of operation,HR and MAP in observation group were lower than those in control group,and the differences were statistically significant(all P<0.05).The eye opening time,spontaneous breathing recovery time,speech response time and extubation time in observation group were shorter than those in control group,and the differences were statistically significant(all P<0.05).The pain scores of the observation group at 6 h,24 h and 48 h after surgery were lower than those of the control group,and the differences were statistically significant(all P<0.05).The cognitive function scores of the observation group were higher than those of the control group on day 1,day 3 and day 7 after operation,and the differences were statistically significant(all P<0.05).The sleep quality scores of the observation group were(13.64±2.19)points,(9.73±1.55)points,(6.74±1.26)points and(4.57±0.27)points at 24 h,2 d,5 d and 10 d after surgery,which were lower than(15.86±2.45)points,(11.29±1.73)points,(8.21±1.43)points and(6.31±0.57)points in the control group,and the differences were statistically significant(t=4.729,4.701,5.399,19.311,all P<0.05).Conclusion Compared with

关 键 词：直肠癌根治术 睡眠质量 硬膜外阻滞 血流动力学 认知功能 

分 类 号：R4[医药卫生—临床医学]