摘要
目的探讨不同呼气末二氧化碳分压对老年腹腔镜卵巢癌根治术患者术后认知功能的影响。方法选择2019年2月—2020年5月淄博市妇幼保健院收治的老年卵巢癌行腹腔镜下根治术者80例为研究对象。按照随机数表法分为两组,各40例。对照组维持术中动脉血二氧化碳分压在35~44 mmHg之间,观察组维持术中动脉血二氧化碳分压在45~55 mmHg之间。比较两组术后6 h认知功能评定主客观指标、术后麻醉苏醒相关指标,统计围麻醉期出现术中知晓和术后认知功能障碍总发生情况。结果术后6 h观察组MMSE评分(28.3±1.1)分明显高于对照组的(25.7±0.5)分,听觉诱发电位中波幅为(6.8±0.2)μV显著低于对照组的(9.2±0.6)μV,潜伏期为(461.8±33.6)ms显著高于对照组的(391.5±15.7)ms,差异有统计学意义(t=13.609、24.000、11.988,P<0.05);观察组呼之睁眼时间、拔管时间及复苏室停留时间分别为(15.8±2.5)、(18.5±2.9)、(25.4±3.3)min均明显短于对照组的(23.9±3.1)、(26.8±3.7)、(38.7±4.7)min,差异有统计学意义(t=12.864、11.166、14.647,P<0.05);观察组围麻醉期出现术中知晓和术后认知功能障碍的总发生率为2.5%,显著低于对照组的22.5%,差异有统计学意义(χ^(2)=7.314,P<0.05)。结论针对老年腹腔镜卵巢癌根治术者,保持术中动脉血二氧化碳分压相对高值,能更好地维持术中镇静状态,改善术后认知功能。
Objective To investigate the effect of different end-tidal carbon dioxide partial pressures on postopera⁃tive cognitive function in elderly patients with laparoscopic radical ovarian cancer surgery.Methods A total of 80 el⁃derly patients with ovarian cancer who underwent laparoscopic radical resection in Zibo Maternal and Child Health Hospital from February 2019 to May 2020 were selected as the research objects.According to the random number table method,they were divided into two groups,each with 40 cases.The control group maintained the intraoperative arterial blood carbon dioxide partial pressure between 35-44 mmHg,and the observation group maintained the intra⁃operative arterial blood carbon dioxide partial pressure between 45-55 mmHg.The subjective and objective indica⁃tors of cognitive function evaluation at 6 h after operation,related indicators of postoperative anesthesia recovery,and the total incidence of intraoperative awareness and postoperative cognitive dysfunction in the peri-anesthesia period were compared between the two groups.Results The MMSE score of the observation group was(28.3±1.1)points significantly higher than that of the control group(25.7±0.5)points 6 h after operation,the amplitude of the auditory evoked potential was(6.8±0.2)μV,which was significantly lower than that of the control group(9.2±0.6)μV,the la⁃tency was(461.8±33.6)ms,which was significantly higher than that of the control group(391.5±15.7)ms,the differ⁃ence was statistically significant(t=13.609,24.000,11.988,P<0.05).In the recovery indicators of anesthesia in the observation group:the time of eye opening,extubation time and the residence time in the resuscitation room were(15.8±2.5)min,(18.5±2.9)min and(25.4±3.3)min were significantly shorter than those in the control group(23.9±3.1)min,(26.8±3.7)min and(38.7±4.7)min,the difference was statistically significant(t=12.864,11.166,14.647,P<0.05).The total incidences of intraoperative awareness and postoperative cognitive dysfunction in the observation group during the peri-anesthesia period were 2.5%,respectively,which were significantly lower than 22.5%in the control group.cases,the difference was statistically significant(χ^(2)=7.314,P<0.05).Conclusion For elderly patients undergoing laparoscopic radical ovarian cancer surgery,maintaining a relatively high intraoperative partial pressure of carbon dioxide in arterial blood can better maintain intraoperative sedation and improve postoperative cognitive function.
作者
刘叶
LIU Ye(Department of Anesthesiology,Zibo Maternal and Child Health Hospital,Zibo,Shandong Province,255000 China)
出处
《系统医学》
2022年第11期56-59,共4页
Systems Medicine
关键词
呼气末二氧化碳分压
老年
卵巢癌根治术
腹腔镜
术后认知功能障碍
End-tidal carbon dioxide partial pressure
The elderly
Ovarian cancer radical surgery
Laparoscopy
Postoperative cognitive dysfunction
