摘要
目的研究丙泊酚与七氟醚对老年腹部手术患者术后免疫功能、血液流变学及认知功能的影响。方法选取2016年3月-2018年5月在我院接受择期腹部手术的老年患者88例,根据麻醉药物不同分为丙泊酚组与七氟醚组,每组44例。观察并记录2组用药后免疫功能、血液流变学以及认知功能变化等。结果 2组血液流变学指标随麻醉时间的延长呈上升趋势,且麻醉后60 min与120 min血黏度、红细胞聚集指数低于麻醉前(P<0.05)。2组术后CD3^+、CD4^+、CD4^+/CD8^+低于术前,CD8^+水平高于术前(P<0.05),但组间比较差异无统计学意义(P>0.05)。2组术后12 h与术后72 h的MMSE评分均低于手术前,且术后12 h低于术后72 h(P<0.05);七氟醚组术后各时间段MMSE评分明显低于丙泊酚组(P<0.05)。结论丙泊酚与七氟醚在老年患者腹部手术中,均可对患者免疫功能、血液流变学与认知功能造成短暂的影响,两种药物均可造成患者机体免疫力的降低与血液流变学异常,同时降低患者认知功能,且七氟醚对患者认知功能影响明显大于丙泊酚。
Objective To study effects of Propofol and Sevoflurane on postoperative immune function, hemorheology and cognitive function in elderly patients undergoing abdominal surgery. Methods A total of 88 elderly patients with elective abdominal surgery during March 2016 and May 2018 were divided into Propofol group(n=44) and Sevoflurane group(n=44) according to different anesthetics. Conditions of immune function, hemorheology and cognitive function after administration were observed and recorded in two groups. Results In two groups, hemorheological indexes were increased with prolonging anesthesia time, and values of plasma viscosity and erythrocyte aggregation index at 60 min and 120 min after anesthesia were significantly decreased compared with those before anesthesia(P<0.05). Levels of CD3^+, CD4^+ and CD4^+/CD8^+ were significantly decreased, while CD8^+ levels were significantly increased compared with those before surgery in two groups(P<0.05), but the differences in the indexes were not statistically significant between groups(P>0.05). Scores of mini-mental state examination(MMSE) at 12 h and 72 h after surgery were significantly lower than those before surgery, and the scores at 12 h after surgery were significantly lower than those at 72 h after surgery in two groups(P<0.05). MMSE scores in Sevoflurane group were significantly lower than those in Propofol group at all time points after surgery(P<0.05). Conclusion Both Propofol and Sevoflurane can have short-term effects on immune function, hemorheology and cognitive function in elderly patients undergoing abdominal surgery. Both drugs can induce decrease of immunity and abnormal hemorheology and reduce cognitive function of patients simultaneously. Sevoflurane has more effect on cognitive function than by Propofol.
作者
杨晓艳
刘杏
李清军
YANG Xiao-yan;LIU Xing;LI Qing-jun(Department of Surgical Anesthesiology,the First People's Hospital of Xianyang,Xianyang,Shaanxi 712000,China;Department of Anesthesiology,the First Hospital of Yulin,Suide,Shaanxi 718000,China)
出处
《解放军医药杂志》
CAS
2019年第11期84-88,共5页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
基金
陕西省教育厅自然科学研究项目(2016JK0773)
