全凭静脉麻醉与吸入七氟烷对老年患者术后认知功能影响的比较
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摘要
目的探讨全凭静脉麻醉与吸入七氟烷对老年患者术后认知功能的影响。方法选取我院收治的120例老年手术患者为研究对象,以麻醉方式异同分为全凭静脉组(n=60,全凭静脉麻醉)和吸入组(n=60,吸入七氟烷),对两组患者苏醒时间、术后认知功能进行观察对比。结果全凭静脉组苏醒时间(17.15±6.85)min、听从指令时间(10.45±2.55)min、定向力恢复时间(11.68±2.32)m i n、P O C D发生率2 3.3 3%均明显低于吸入组[(3 1.0 4±9.8 6)m i n、(13.30±2.70)min、(15.27±2.63)min、41.67%],且术后各时间段MMSE评分明显高于吸入组,P<0.05。结论采用全凭静脉麻醉的方式对老年手术患者术后认知功能影响更小,且患者苏醒时间短,有利于术后迅速恢复,值得临床应用。
Objective To investigate the effect of intravenous anesthesia and inhalation of sevoflurane on cognitive function in elderly patients. Methods 120 elderly patients were selected as the subjects, and the anesthesia was divided into all the intravenous group(n=60,total intravenous anesthesia) and inhalation group(n=60,inhaled sevoflurane) The awakening time and postoperative cognitive function of the two groups were observed and compared. Results The recovery time(11.68±2.32) min and the incidence of cognitive impairment were significantly lower than those in the inhalation group(17.15±6.85) min,(10.65±2.55)min,(31.04±9.86) min,(13.30±2.70) min,(15.27±2.63) min, 41.67%, and MMSE scores were significantly higher in the respective groups than in the inhalation group(P<0.05). Conclusion The effect of full-time intravenous anesthesia on the cognitive function of the elderly patients is less, and the recovery time is short, which is beneficial to the rapid recovery after operation and is worthy of clinical application.
Objective To investigate the effect of intravenous anesthesia and inhalation of sevoflurane on cognitive function in elderly patients. Methods 120 elderly patients were selected as the subjects, and the anesthesia was divided into all the intravenous group(n=60,total intravenous anesthesia) and inhalation group(n=60,inhaled sevoflurane) The awakening time and postoperative cognitive function of the two groups were observed and compared. Results The recovery time(11.68±2.32) min and the incidence of cognitive impairment were significantly lower than those in the inhalation group(17.15±6.85) min,(10.65±2.55)min,(31.04±9.86) min,(13.30±2.70) min,(15.27±2.63) min, 41.67%, and MMSE scores were significantly higher in the respective groups than in the inhalation group(P<0.05). Conclusion The effect of full-time intravenous anesthesia on the cognitive function of the elderly patients is less, and the recovery time is short, which is beneficial to the rapid recovery after operation and is worthy of clinical application.
引文
1陈红转,刘雅,康荣田.多重监测下的全凭静脉麻醉对老年患者术后认知功能的影响[J].临床麻醉学杂志,2017,33(2):152~156
2高友光,林献忠,林财珠,等.不同麻醉方法下老年患者术后认知功能障碍发生的比较[J].中华麻醉学杂志,2016,36(11):1337~1340
3樊素雄,王彦.丙泊酚和七氟烷麻醉对老年患者普通胸外科手术后认知功能的影响[J].中国现代药物应用,2017,11(3):24~26
4邱爽,董有静,段丽芳,等.七氟烷与异丙酚对老年肺癌患者局部脑氧饱和度及术后早期认知功能的影响[J].中国医科大学学报,2016,45(9):797~800
5毕明超,王永强.丙泊酚与七氟烷分别复合芬太尼对普外科胸部手术后认知功能的影响[J].国际医药卫生导报,2017,23(1):80~83
6于刚,王海珍,曹开梅,等.老年患者手术应用不同全麻麻醉方式对术后认知功能影响的比较分析[J].国际医药卫生导报,2016,22(16):2409~2411
7李国肖,卢跃.靶控输注全凭静脉麻醉对老年患者术后认知功能的影响[J].中华全科医学,2013,(01):87~88
8许艳淑,陈琦,王英伟.全凭静脉麻醉与吸入麻醉对老年患者术后认知功能影响的比较[J].上海医学,2009,(01):50~53
9赵江.瑞芬太尼与芬太尼对老年人全身麻醉术后认知功能的影响[J].中国老年学杂志,2011,(23):4696~4697
10李刚,刘广忠.吸入麻醉与全凭静脉麻醉在神经外科手术中的应用效果比较[J].中国实用神经疾病杂志,2015,(06):86~88
11李志华,马明轩,李云林,等.靶控输注瑞芬太尼-丙泊酚麻醉在癫痫手术的应用效果及对皮质脑电监测的影响[J].临床神经外科杂志,2013,(03):174~175,17
2高友光,林献忠,林财珠,等.不同麻醉方法下老年患者术后认知功能障碍发生的比较[J].中华麻醉学杂志,2016,36(11):1337~1340
3樊素雄,王彦.丙泊酚和七氟烷麻醉对老年患者普通胸外科手术后认知功能的影响[J].中国现代药物应用,2017,11(3):24~26
4邱爽,董有静,段丽芳,等.七氟烷与异丙酚对老年肺癌患者局部脑氧饱和度及术后早期认知功能的影响[J].中国医科大学学报,2016,45(9):797~800
5毕明超,王永强.丙泊酚与七氟烷分别复合芬太尼对普外科胸部手术后认知功能的影响[J].国际医药卫生导报,2017,23(1):80~83
6于刚,王海珍,曹开梅,等.老年患者手术应用不同全麻麻醉方式对术后认知功能影响的比较分析[J].国际医药卫生导报,2016,22(16):2409~2411
7李国肖,卢跃.靶控输注全凭静脉麻醉对老年患者术后认知功能的影响[J].中华全科医学,2013,(01):87~88
8许艳淑,陈琦,王英伟.全凭静脉麻醉与吸入麻醉对老年患者术后认知功能影响的比较[J].上海医学,2009,(01):50~53
9赵江.瑞芬太尼与芬太尼对老年人全身麻醉术后认知功能的影响[J].中国老年学杂志,2011,(23):4696~4697
10李刚,刘广忠.吸入麻醉与全凭静脉麻醉在神经外科手术中的应用效果比较[J].中国实用神经疾病杂志,2015,(06):86~88
11李志华,马明轩,李云林,等.靶控输注瑞芬太尼-丙泊酚麻醉在癫痫手术的应用效果及对皮质脑电监测的影响[J].临床神经外科杂志,2013,(03):174~175,17