老年患者丙泊酚麻醉后认知功能异常分析及血清过氧化酶类的变化研究

目的:探讨老年患者丙泊酚全凭静脉麻醉后其认知功能及血清过氧化酶类的变化。方法:回顾性分析2013年至2015年间经本院收治的行大肠癌根治术的56例大肠癌伴有冠心病患者的临床资料,利用随机分组的方式将56例患者分为观察组(利用丙泊酚全凭静脉麻醉)及对照组(利用异氟烷静吸复合麻醉),每组患者28例。记录患者术前术后的简易智能状态检查量表(mini-mental state examination,MMSE)评分以及心率、平均动脉压、用药量、麻醉时间及手术时间等指标。利用酶联免疫吸附法(enzyme linked immuno sorbent assay,ELISA)测量所有研究对象的血清髓过氧化酶水平变化。结果:观察组患者术后发生认知功能异常的有5例,发生率为17.86%;对照组患者术后发生认知功能异常的有9例,发生率为32.14%;将两组患者的MMSE评分进行比较发现,对照组患者术后MMSE评分较术前下降程度比观察组患者更明显(P<0.05);两组患者的术前血清髓过氧化酶水平差异无统计学意义,但术后观察组患者的血清髓过氧化酶水平下降程度明显高于对照组患者(P<0.05)。结论:老年患者丙泊酚全凭静脉麻醉能够有效改善患者术后认知功能异常及血清髓过氧化酶水平,为临床麻醉药物选择提供参考。

Analysis of cognitive dysfunction in elderly patients after propofol anesthe-sia and the changes of serum peroxidase

Objective:To investigate the changes of cognitive function and serum peroxidase in elderly patients after total intra-venous anesthesia with propofol.Methods:Retrospectively analyzed of 56 cases of colorectal cancer associated with coronary heart dis-ease during 2013 -2015 in our hospital underwent radical resection for colorectal carcinoma.56 patients were randomly divided into ob-servation group (using propofol total intravenous anesthesia)and control group (using isoflurane anesthesia),28 cases in each.Mini-Mental State Examination(MMSE)score,heart rate,mean arterial pressure,dosage,duration of anesthesia and operation time index in patients were recorded before and after surgery.Using enzyme-linked immunosorbent assay (ELISA),serum level changes of myeloper-oxidase in all subjects was measured.Results:After the operation,5 cases of the patients in observation group has cognitive dysfunction, and the incidence rate is 17.86%,9 cases of the patients in control group has cognitive dysfunction,and the incidence rate was 32. 14%.Compared the MMSE scores of two groups,MMSE score in the control group compared with the preoperative decline degree is more obvious than the patients in the observation group (P<0.05 ).There is no statistical difference between two groups of patients with serum myeloperoxidase level.However,compared with the control group,the degree of decline of serum medullary peroxidase lev-els in the observation group was significantly higher(P<0.05).Conclusion:The elderly patients with propofol for total intravenous an-esthesia can effectively improve the postoperative cognitive function and the level of serum myeloperoxidase,provide reference for the se-lection of clinical anesthesia drugs.