摘要
目的分析七氟烷与丙泊酚对老年肺癌根治术患者术后认知功能影响。方法选择2014年8月—2017年5月遵化市人民医院行肺癌根治术老年患者124例,按麻醉方法分为七氟烷组和丙泊酚组,每组62例。七氟烷组术中采用七氟烷实施麻醉维持,丙泊酚组术中采用丙泊酚实施麻醉维持。观察两组术后麻醉和苏醒情况,手术前后简明精神状态量表(MMSE)评分、焦虑和抑郁及术后认知功能障碍(POCD)发生情况、血清S100β蛋白水平,记录不良反应发生情况。结果七氟烷组自主呼吸时间、开始睁眼时间和拔管时间均短于丙泊酚组(P<0.05)。七氟烷组术后6 h、术后1、3 d MMSE评分均高于丙泊酚组(P<0.05)。术后1 d,七氟烷组抑郁自评量表(SDS)和焦虑自评量表(SAS)评分均低于丙泊酚组(P<0.05)。术后1、3 d,七氟烷组POCD发生率低于丙泊酚组(P<0.05)。术后10 min,术后1、3 d,七氟烷组血清S100β蛋白水平低于丙泊酚组(P<0.05)。两组不良反应比较差异无统计学意义(P>0.05)。结论老年肺癌根治术采用七氟烷维持麻醉,对术后认知功能的影响较丙泊酚小,利于术后POCD恢复。
Objective To analyze effects of Sevoflurane and Propofol on postoperative cognitive function in elderly patients with lung cancer undergoing radical resection. Methods A total of 124 elderly patients with lung cancer undergoing radical resection during August 2014 and May 2017 were divided into Sevoflurane group( n = 62) and Propofol group( n = 62) according to different anesthetic methods. Sevoflurane group was given Sevoflurane for intraoperative anesthesia maintenance,while Propofol group received Propofol for intraoperative anesthesia maintenance. Postoperative anesthesia and palinesthesia conditions,the mini-mental state examination( MMSE) score,incidence conditions of anxiety,depression and postoperative cognitive dysfunction( POCD) and serum S100β protein levels before and after operation were observed,and incidence rate of adverse reactions was recorded in two groups. Results Spontaneously breathing,beginning eye opening and extubation times in Sevoflurane group were significantly shorter than those in propofol group( P < 0. 05). MMSE scores at postoperative 6 thh,1 std and 3 thd in Sevoflurane group were significantly higher than those in Propofol group( P < 0. 05). At postoperative 1 std,self-rating depression scale( SDS) and self-rating anxiety scale( SAS) scores in Sevoflurane group were significantly lower than those in Propofol group( P < 0. 05). At postoperative 1 st d and 3 thd,POCD incidence rates in Sevoflurane group were significantly lower than those in Propofol group( P < 0. 05).At postoperative 10 thmin,1 std and 3 thd,serum S100β protein levels in Sevoflurane group were significantly lower than those in Propofol group( P < 0. 05). There was no significant difference in incidence rate of adverse reactions between two groups( P > 0. 05). Conclusion Sevoflurane in application of elderly patients with lung cancer undergoing radical resection for anesthesia maintenance may has little effect on POCD than that by Propofol,and it is beneficial to postoperative recovery of cognitive function.
出处
《解放军医药杂志》
CAS
2018年第2期5-8,共4页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
基金
河北省卫生厅课题项目(20171404)
关键词
肺肿瘤
七氟烷
丙泊酚
老年人
认知障碍
Lung Neoplasm
Sevoflurane
Propofol
Aged
Cognition disorders
