丙泊酚对老年手术患者术后认知功能的影响

发布时间：2018-05-20 05:55

本文选题：丙泊酚 + 认知功能障碍　；参考：《中国老年学杂志》2017年18期

【摘要】：目的观察丙泊酚对老年手术患者术后认知功能的影响。方法选取行胸、腰椎经皮球囊扩张椎体后凸成形术患者70例,随机分为观察组与对照组,每组各35例。记录两组入室时(T1)、术中(T2)、拔除气管导管前(T3)3个时间点的平均动脉压(MAP)、心率(HR)和脉搏血氧饱和度(SPO2),对比两组睁眼时间、应答时间、定向力恢复时间及手术后疼痛情况;采用简易智力状态检查量表(MMSE)评估患者术前、术后3 h及术后1 d的认知状态。结果观察组睁眼时间[(8.36±0.99)min]明显短于对照组[(10.08±1.06)min,t=2.69,P=0.012];观察组应答时间[(9.41±1.93)min]明显短于对照组[(11.69±2.03)min,t=2.91,P=0.007];观察组定向力恢复时间[(10.23±2.37)min]明显短于对照组[(11.42±2.18)min,t=2.89,P=0.008];观察组视觉模拟评分(VAS)(3.30±1.03)与对照组(3.31±1.78)无显著差异(t=0.86,P=0.46);术前及术后1 d两组患者MMSE评分比较无统计学差异(t=0.31,P=0.76;t=0.57,P=0.77);术后3 h观察组MMSE评分明显高于对照组(t=2.74,P=0.77)。结论丙泊酚对于老年患者术中镇痛效果良好,麻醉不良反应小,同时有效降低了患者术后认知功能障碍的发生。
[Abstract]:Objective to observe the effect of propofol on postoperative cognitive function in elderly patients. Methods 70 patients with thoracolumbar percutaneous balloon kyphoplasty were randomly divided into observation group and control group with 35 cases in each group. The mean arterial pressure (MAPP), heart rate (HRT) and pulse oxygen saturation (SPO _ 2) were recorded at three time points (T1, T2, T3) in the two groups. The time of eye opening, response time, recovery time of directional force and pain after operation were compared between the two groups. MMSE was used to evaluate the cognitive state of the patients before operation, 3 hours after operation and 1 day after operation. Results the eye opening time of the observation group [8.36 卤0.99)min] was significantly shorter than that of the control group [10.08 卤1.06min], the response time of the observation group [9.41 卤1.93)min] was significantly shorter than that of the control group [11.69 卤2.03min], the recovery time of the observation group [10.23 卤2.37)min] was significantly shorter than that of the control group [10.42 卤2.18min], and the visual simulation score of the observation group was 3.30 卤1.03 and 3.31 卤1.78respectively. There was no significant difference in MMSE score between the two groups before and 1 day after operation. The MMSE score in the observation group was significantly higher than that in the control group at 3 hours after operation. Conclusion propofol has a good analgesic effect and less adverse anesthetic reaction in elderly patients, and it can effectively reduce the incidence of postoperative cognitive dysfunction.
【作者单位】：温州医科大学附属第二医院麻醉科;苏州大学附属第一医院麻醉科;
【基金】：浙江省医药卫生科技计划项目(2016KYA140)
【分类号】：R614

【相似文献】