丙泊酚复合舒芬太尼靶控静脉麻醉对老年肺癌患者术中血流动力学及术后认知功能的影响

发布时间：2018-05-24 15:39

本文选题：靶控静脉麻醉 + 丙泊酚　；参考：《中国老年学杂志》2017年11期

【摘要】：目的探讨丙泊酚复合舒芬太尼靶控静脉麻醉对老年肺癌患者术中血流动力学及术后认知功能的影响。方法行肺癌根治手术的老年肺癌患者45例,按照随机数字表法分为观察组(24例)和对照组(21例),分别给予丙泊酚复合舒芬太尼靶控静脉麻醉和静吸复合麻醉。在进入手术室(T0)、诱导插管后(T1)、进胸时(T2)、拔管时(T3)、拔管后10 min(T4)监测患者平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO_2)变化;并采用简易精神状态量表(MMSE)评估患者认知功能。结果术后1 d时,观察组认知功能障碍(POCD)发生率明显低于对照组(P0.05)。术后3 d时,两组POCD发生率的差异无统计学意义(P0.05)。术前1 d和术后3 d时,两组MMSE评分差异均无统计学意义(P0.05)。术后1 d时,两组MMSE评分均降低,且观察组高于对照组(P0.05);术后3 d时,MMSE评分逐渐恢复到正常水平,组间比较差异无统计学意义(P0.05)。T0和T4时,两组MAP、HR和SpO_2水平差异均无统计学意义(P0.05),T1、T2和T3时,观察组MAP和HR水平均显著低于对照组(P0.05),两组各个时间点SpO_2水平差异均无统计学意义(P0.05)。结论丙泊酚复合舒芬太尼靶控静脉麻醉对患者术后认知功能减退恢复更快,维持血流动力学稳定效果更好,更适用于老年肺癌患者的胸科手术麻醉。
[Abstract]:Objective to investigate the effect of propofol combined with sufentanil target controlled intravenous anesthesia on hemodynamics and postoperative cognitive function in elderly patients with lung cancer. Methods Forty-five elderly patients with lung cancer undergoing radical lung cancer operation were randomly divided into observation group (n = 24) and control group (n = 21). Propofol combined with sufentanil were given target controlled intravenous anesthesia and intravenous anesthesia. The changes of mean arterial pressure (MAPP), heart rate (HRP), and oxygen saturation (SPO _ 2) were monitored in patients with T0, T1, T _ 2, T _ 3, T _ 3 and T _ 4 respectively after intubation, and MMSE were used to evaluate the cognitive function of the patients. Results 1 day after operation, the incidence of POCD in the observation group was significantly lower than that in the control group (P 0.05). At 3 days after operation, there was no significant difference in the incidence of POCD between the two groups (P 0.05). There was no significant difference in MMSE score between the two groups 1 day before operation and 3 days after operation (P 0.05). On the 1st day after operation, the MMSE scores of the two groups decreased, and those in the observation group were higher than those in the control group (P 0.05), and gradually returned to the normal level on the 3rd day after operation, and there was no significant difference between the two groups at P0.05U. T0 and T4. The levels of MAP and HR in the observation group were significantly lower than those in the control group (P 0.05). There was no significant difference in the levels of SpO_2 between the two groups at different time points (P 0.05). Conclusion Target controlled intravenous anesthesia combined with propofol and sufentanil can improve the recovery of cognitive function and maintain hemodynamic stability in patients with lung cancer, and is more suitable for thoracic anesthesia in elderly patients with lung cancer.
【作者单位】：南充市中心医院麻醉科;
【分类号】：R614;R734.2

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