腰硬联合麻醉对腹腔镜阑尾切除术后高龄患者认知功能障碍的影响

发布时间：2018-01-19 16:09

本文关键词： 腰硬联合麻醉腹腔镜阑尾切除术认知功能障碍 β-淀粉样蛋白神经元微管相关蛋白　出处：《中国老年学杂志》2015年02期 　论文类型：期刊论文

【摘要】：目的探讨腰硬联合麻醉对腹腔镜阑尾切除术后高龄患者认知功能障碍及血β-淀粉样蛋白(Aβ)和神经元微管相关蛋白(Tau)的影响。方法行腹腔镜阑尾切除术的高龄患者84例,随机分成对照组和观察组各42例。对照组单独采用全身麻醉,观察组采用腰硬联合麻醉。结果术后1 d,对照组简易智能量表(MMSE)评分(21.39±2.54)低于术前(27.04±1.49),且对照组(21.39±2.54)低于观察组(26.51±1.85)(P0.01)。观察组MMSE评分不同时间段相比差异不显著(P0.05)。术后1 d,对照组Aβ和Tau的含量与治疗前相比显著升高,且明显高于观察组(P0.01)。观察组Aβ和Tau的含量不同时间段相比差异不显著(P0.05)。术后1 d,观察组术后认知功能障碍(POCD)发生率(16.67%)低于对照组(45.24%)(P0.01)。术后6 d,两组POCD发生率比较差异不显著(P0.05)。结论全麻能增加腹腔镜阑尾切除术患者术后早期认知功能障碍的发生率,Aβ和Tau蛋白浓度升高可能是POCD发生的原因之一。腰硬联合麻醉可以通过控制Aβ和Tau蛋白浓度,有效减少患者术后早期认知功能障碍的发生率。
[Abstract]:Objective to investigate the effects of combined spinal-epidural anesthesia on cognitive dysfunction and serum 尾 -amyloid A 尾 and neuron microtubule-associated protein (Tauau) in elderly patients after laparoscopic appendectomy. Methods 84 elderly patients underwent laparoscopic appendectomy. Two groups were randomly divided into two groups: the control group (n = 42) and the observation group (n = 42). The control group was treated with general anesthesia alone and the observation group with combined spinal-epidural anesthesia. The MMSE score of the control group was 21.39 卤2.54 and 27.04 卤1.49 respectively. The control group (21.39 卤2.54) was lower than the observation group (26.51 卤1.85) (P 0.01). There was no significant difference in MMSE score between the observation group and the observation group (P 0.05). 1 day after operation. The levels of A 尾 and Tau in the control group were significantly higher than those before treatment. The contents of A 尾 and Tau in the observation group were not significantly different from those in the observation group at different time periods (P 0.05), and 1 day after the operation, there was no significant difference in the content of A 尾 and Tau between the observation group and the observation group. The incidence of POCD in the observation group was significantly lower than that in the control group (P 0.01). There was no significant difference in the incidence of POCD between the two groups (P 0.05). Conclusion General anesthesia can increase the incidence of early cognitive dysfunction after laparoscopic appendectomy. The increase of A 尾 and Tau protein concentration may be one of the causes of POCD. Combined spinal-epidural anesthesia can control A 尾 and Tau protein concentration. To reduce the incidence of early postoperative cognitive dysfunction.
【作者单位】：吉安市中心人民医院麻醉科;解放军总医院第一附属医院麻醉科;
【基金】：吉安市科技局指导性科技计划(No.吉市科计字〔2012〕32号:60)
【分类号】：R614
【正文快照】： 术后认知功能障碍(POCD)是老年患者手术后常见的并发症〔1〕。临床表现为精神错乱、焦虑、人格改变及记忆受损,严重的可发展成永久性老年性痴呆〔2〕。研究认为〔3〕,选择合适的麻醉能有效控制患者POCD的发生。本研究中采用腰硬联合麻醉用于腹腔镜阑尾切除术,并观察腰硬联合麻

【相似文献】