石杉碱甲对老年患者腹部手术后认知功能障碍的双盲研究

目的研究石杉碱甲对老年患者腹部手术后认知功能障碍的影响。方法收集行择期腹部手术的老年患者100例，ASAⅠ-Ⅱ级，年龄65岁～86岁，无神经、精神系统疾病史。治疗组患者50例，麻醉前静脉注射石杉碱甲注射液0．2mg，对照组50例注射等容量（1mL）的生理氯化钠溶液。观察两组患者术前、术后8、12、24h、术后1周的认知功能，采用简易智能状态检查法（Mini—Mental State Examination，MMSE）测试，观察两组患者术后认知功能障碍、术后谵妄的发生情况及苏醒时间。结果两组患者术前MMSE评分无显著差异；与术前比较，对照组术后各时间点的MMSE评分均下降（P〈0．05），治疗组于术后1、12、24h下降（P〈0．05），但术后1周与术前无显著差异（P〉0．05）；两组间比较治疗组术后各时点的MMSE评分均高于对照组（P〈0．05）。术后认知功能障碍和术后谵妄的发生率治疗组明显低于对照组（P〈0．05）。苏醒时间两组间无显著性差异（P〉0．05）。结论围术期应用石杉碱甲注射液可减少老年患者全麻术后认知功能的损害，降低术后认知功能障碍的发生。

The Effect of Huperzine on Cognitive Dysfunction After Abdomenal Surgery in elder Patients

Aim To research the effect of huperzine on cognitive dysfunction after abdomenal surgery in aged patients. Methods One hundred ASA Ⅰ - Ⅱ patients undergoing abdominal surgery, aged 65 to 86 who had no were selected disease history of the nervous and psychiatrtric system. The treatment group recieved intravenously huperzine 0.2mg and the control group recieved 0.9% salie lml respectively before anesthesia. Cognitive functions of all patients were observed and evaluated with Mini-Mental State Examination（MMSE） before operation and 8,12, 24h and 1 week after operation. The level of cognitive dysfunction and delirium and recovery time were observed. Results There was no significant difference in the MMSE score between the two groups preoperatively. However, in the control group the MMSE score was significantly lower （ P 〈 0.05 ）. In the treatment group MMSE score declined significantly 1,12h and 24h after operation（ P 〈 0.05 ）. Between the two groups, there was significant difference in the MMSE score after operation（P 〈0.05 ）. The in cidence of cognitive dysfunction and delirium was significantly lower in the treatment group than in the control group. There was no significant difference in the recovery time between the two groups Conclusion Huperzine can prevent postoperative cognitive dysfunction in aged patients while significantly alleviating the injury of cognitive dysfunction after general anesthesia.