脑电双频指数对全麻下老年患者腹腔镜胃癌根治术术后认知功能障碍的影响

发布时间：2018-05-18 23:42

本文选题：脑电双频指数 + 老年人　；参考：《广东医学》2017年18期

【摘要】：目的观察脑电双频指数(BIS)监测对全麻下老年患者腹腔镜胃癌根治术术后认知功能障碍(POCD)的影响。方法拟行腹腔镜胃癌根治术的老年患者60例,随机分为观察组和对照组,每组30例,所有患者实行气管插管全身麻醉,观察组术中调整七氟烷和瑞芬太尼用量,维持BIS值40~59。对照组根据临床经验调整七氟烷和瑞芬太尼用量。记录七氟烷、瑞芬太尼用量及不良反应发生率。测定患者手术前1 d(T0)、手术结束时(T1)、手术后第1天(T2)和手术后第3天(T3)血浆S100β浓度,并在T0、T2、T3时点完成简易精神状态检查量表(MMSE)评分,记录POCD发生率。结果观察组术中七氟烷和瑞芬太尼用量低于对照组(P0.05),术中低血压发生率低于对照组(P0.05)。两组术毕S100β水平高于其他时点(P0.05),观察组术毕S100β水平低于对照组(P0.05)。观察组术后第1天MMSE评分高于对照组(P0.05),POCD发生率低于对照组(P0.05)。结论行腹腔镜胃癌根治术的老年患者,在BIS监测下实施麻醉,可降低血清S100β水平,减少POCD和术中低血压的发生率。
[Abstract]:Objective to observe the effect of bispectral index (BIS) monitoring on cognitive dysfunction (POCD) after laparoscopic radical gastrectomy in elderly patients with gastric cancer under general anesthesia. Methods Sixty elderly patients with gastric cancer undergoing laparoscopic radical gastrectomy were randomly divided into observation group and control group with 30 patients in each group. All patients were subjected to general anesthesia with tracheal intubation. The dosage of sevoflurane and remifentanil was adjusted during operation in the observation group and the BIS value was maintained at 4059. The control group adjusted the dosage of sevoflurane and remifentanil according to clinical experience. Sevoflurane, remifentanil dosage and adverse reactions were recorded. The plasma S100 尾 levels were measured 1 day before operation, 1 day after operation, and 3 days after operation. MMSE scores were completed at T0 and T2T3, and the incidence of POCD was recorded. Results the dosage of sevoflurane and remifentanil in the observation group was lower than that in the control group, and the incidence of hypotension in the observation group was lower than that in the control group. The level of S100 尾 at the end of operation in both groups was higher than that in other time points (P 0.05), and the level of S100 尾 in observation group was lower than that in control group (P 0.05). The incidence rate of MMSE in the observation group was higher than that in the control group on the first day after operation, and was lower than that in the control group. Conclusion Anesthesia under BIS monitoring can decrease serum S100 尾 level, POCD and the incidence of hypotension in the elderly patients undergoing laparoscopic radical gastrectomy.
【作者单位】：深圳市人民医院暨南大学医学院第二附属医院麻醉科深圳市麻醉医学工程研究中心;
【基金】：深圳市科技计划项目(编号:JCYJ20140416122812032)
【分类号】：R614.2;R735.2

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