摘要
目的探讨不同麻醉方式对妇科开腹手术患者术后早期认知功能的影响。方法选取美国麻醉师协会(ASA)Ⅰ级择期行妇科开腹手术患者120例,随机分为全身麻醉组(A组)和椎管内麻醉组(B组),2组均无术前用药,所有患者接受术后静脉镇痛,药物为芬太尼与昂丹司琼。在术前1d,术后1、6、24、48、72h记录患者血压、心率和认知功能简易精神状态检查量表(MMSE)值的变化。结果 A组与B组比较,在术后1、6、24、48、72h时点MMSE值明显降低(P<0.01)。结论全身麻醉患者术后早期MMSE评分下降较硬膜外麻醉者显著,术后认知功能障碍的发生率明显高于硬膜外麻醉者。
Objective To investigate the effect of two type of anesthesia on postoperative cognitive dysfunction in female patients undergoing laparotomy. Methods One hundred and twenty ASA physical status Ⅰ patients with hysteromyoma received laparotomy with two different anesthesia type：the group of general anesthesia （group A） or the group of spinal anesthesia （group B）. All patients received no premedication and patients were controlled analgesia with fentanil and ondansetron. Blood pressure,heart rate and score of mini-mental state were recorded at the day before operation and 1,6,48,72 h after operation. Results MMSE value significantly decreased at 1,6,24,48 and 72 h after operation in Ⅱ group,as compared with I group（P0.01）.Conclusion The score of cognitive function and incidence of cognitive dysfunction after general anesthesia were lower than that after epidural anesthesia.
基金
辽宁省教育厅课题(2008084)
关键词
麻醉
妇科外科手术
认知障碍
Anesthesia
Gynecologic surgical procedures
Cognition disorders
