丙泊酚与瑞芬太尼静吸复合麻醉对老年腹腔镜下胆囊切除术患者术后认知功能的影响

发布时间：2018-03-25 04:30

本文选题：腹腔镜胆囊切除术　切入点：术后认知功能　出处：《中国老年学杂志》2015年02期

【摘要】：目的探讨靶控静脉输注丙泊酚复合瑞芬太尼麻醉与静吸复合麻醉对老年经腹腔镜胆囊切除术患者术后认知功能的影响。方法选取2009年1月至2014年1月该院收治的80例行胆囊切除术患者,随机分为靶控静脉麻醉组及静吸复合麻醉组各40例。观察两组患者术后恢复情况,并比较两组手术前后认知功能。结果两组患者苏醒时间、拔管时间比较差异均无统计学意义(P0.05);靶控静脉麻醉组患者自主呼吸恢复时间、定向力恢复时间均长于静吸复合麻醉组(P0.05)。两组术前24 h和拔管后12 h的简易智能量表(MMSE)评分比较差异均无统计学意义(P0.05);拔管后1、3 h靶控静脉麻醉组MMSE评分低于静吸复合麻醉组(P0.05)。结论丙泊酚与瑞芬太尼静吸复合麻醉较靶控静脉麻醉对老年腹腔镜下胆囊切除术后认知功能的恢复有更好的效果,且对术后认知功能影响较小,可降低老年患者术后认知功能障碍的发生,适用于老年患者。
[Abstract]:Objective to investigate the effect of target-controlled intravenous infusion of propofol combined with remifentanil and intravenous inhalation on cognitive function in elderly patients undergoing laparoscopic cholecystectomy. 80 patients underwent cholecystectomy, Patients were randomly divided into target controlled intravenous anesthesia group (n = 40) and intravenous anesthesia group (n = 40). The recovery of patients after operation was observed, and the cognitive function before and after operation was compared between the two groups. There was no significant difference in extubation time (P 0.05). The recovery time of directional force was longer than that of intravenous combined anesthesia group (P 0.05). There was no significant difference between the two groups in the scores of mini-intelligence scale 24 hours before operation and 12 hours after extubation, and the MMSE score of target controlled intravenous anesthesia group was lower than that of static anesthesia group at 1 h 3 h after extubation. Conclusion combined intravenous anesthesia with propofol and remifentanil has a better effect on the recovery of cognitive function after laparoscopic cholecystectomy in elderly patients than that under target-controlled intravenous anesthesia. It has little effect on postoperative cognitive function and can reduce the occurrence of postoperative cognitive dysfunction in elderly patients.
【作者单位】：重庆医科大学附属永川医院麻醉科;
【基金】：国家自然科学基金(81171034)
【分类号】：R614

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