丙泊酚复合芬太尼全凭静脉麻醉对老年胸外科手术后认知功能的影响

发布时间：2018-11-04 17:00

【摘要】：目的研究丙泊酚复合芬太尼全凭静脉麻醉对老年胸外科手术后认知功能的影响。方法选择2010年5月至2013年5月在该院接受胸外科手术治疗的老年患者90例,根据数字表法随机分成观察组及对照组各45例,观察组使用丙泊酚+维库溴铵+芬太尼诱导,对照组使用七氟烷+维库溴铵+芬太尼诱导,对比两组手术相关指标、不同时间的简易智力状态评测表(MMSE)评分情况以及两组手术前后心率(HR)、血压及血清S100β蛋白等指标水平。结果观察组的术后睁眼时间及拔管时间均显著少于对照组(均P0.05),而两组手术时间和单肺通气时间差异均无统计学意义。观察组术后1、3 h的MMSE评分均显著低于术前,对照组术后1、3、6 h的MMSE评分均显著低于术前,且低于观察组(均P0.05),而两组术前和术后24、72 h的MMSE评分差异均无统计学意义;两组手术前后的HR、收缩压(SBP)及舒张压(DBP)差异均无统计学意义;观察组术前的血清S100β蛋白水平与对照组差异不显著,但术后的血清S100β蛋白水平显著低于对照组(P0.05)。结论丙泊酚与芬太尼的复合全麻对老年胸外科手术患者术后的认知功能具有一过性的影响,但与七氟烷相比,认知功能的恢复速度较快,且手术后患者血清S100β蛋白的含量水平较低。
[Abstract]:Objective to study the effect of propofol combined with fentanyl total intravenous anesthesia on cognitive function in elderly patients undergoing thoracic surgery. Methods from May 2010 to May 2013, 90 elderly patients undergoing thoracic surgery were randomly divided into two groups: observation group (n = 45) and control group (n = 45). The observation group was induced by propofol vecuronium bromide fentanyl. The control group was induced by sevoflurane vecuronium bromide fentanyl. The indexes related to operation, the (MMSE) score of simple mental state evaluation form at different time and the heart rate (HR), before and after operation were compared between the two groups. Blood pressure and serum S100 尾 protein level. Results the time of eye opening and extubation in the observation group was significantly less than that in the control group (P0.05), but there was no significant difference in the operation time and the time of single lung ventilation between the two groups. The MMSE score of the observation group was significantly lower than that of the preoperative group at 1: 3 h after operation, and the MMSE score of the control group was significantly lower than that of the control group at 1: 3 and 6 h postoperatively (P0.05). However, there was no significant difference in the MMSE score between the two groups at 24 ~ 72 hours after operation. There was no significant difference in HR, systolic blood pressure (SBP) and diastolic blood pressure (DBP) between the two groups before and after operation. The serum S100 尾 protein level in the observation group was not significantly different from that in the control group, but the serum S100 尾 protein level after operation was significantly lower than that in the control group (P0.05). Conclusion the combined general anesthesia of propofol and fentanyl has a temporary effect on the cognitive function of elderly patients undergoing thoracic surgery, but the recovery rate of cognitive function is faster than that of sevoflurane. The level of serum S 100 尾 protein was lower after operation.
【作者单位】：河南省胸科医院麻醉二科;
【分类号】：R614

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