麻醉诱导后不同维持麻醉方法对老年肿瘤患者手术后认知功能的影响研究

目的：探讨麻醉诱导后不同维持麻醉方法对老年肿瘤患者术后认知功能的影响。方法以行外科手术的96例老年肿瘤患者为研究对象，按麻醉诱导后麻醉维持方法进行分组，A组（45例）采取静脉泵注丙泊酚+吸入异氟醚维持麻醉，B组（51例）采取持续静脉泵注丙泊酚维持麻醉，比较两组患者术后苏醒情况和认知功能。结果 B组术后苏醒时间、拔管时间、话语时间为（42.5±8.5）min、（86.5±26.5）min、（105.3±43.5）min，各项苏醒指标同A组比较差异均无统计学意义（P﹥0.05）；两组患者拔管后1 h的简易精神状态检查表（MMSE）评分均低于术前（P﹤0.05），A、B组拔管后6 h的MMSE评分分别为（26.2±1.5）分和（28.8±0.5）分，B组患者认知功能恢复要优于A组（P﹤0.01）。A组、B组拔管24 h后术后认知功能障碍发生率为8.89%（4/45）、7.84%（4/51），差异无统计学意义（P﹥0.05）。结论相较于静吸复合麻醉维持，全凭静脉麻醉维持对老年肿瘤患者术后认知功能的影响较小，患者恢复认知功能较快，值得临床进一步研究。

Study on the influence of different maintaining anesthesia regimen after induction of anesthesia on postoperative cognitive function of elderly patients with cancer

Objective To investigate the effects of different maintaining anesthesia regimen on the postoperative cog-nitive function in elderly patients with tumor after anesthesia induction. Method 96 cases of elderly patients with cancer were enrolled in the study, and were stratified as group A (n=45) or group B (n=51), as per the respective maintaining an-esthesia regimen, with intravenous infusion of propofol combined with isoflurane inhalation in group A, and continuous intravenous infusion of propofol in group B. Analepsia and cognitive function in the two groups were then compared. Re-sult After surgery, the analepsia time, extubation time and talk time of group B were (42.5±8.5) min, (86.5±26.5) min, and (105.3 ± 43.5) min, respectively, which were similar with group A (P>0.05);In 1h after extubation, MMSE scores of both groups were significantly lower than that before surgery;And the MMSE score in 6h after extubation of group A and B was (26.2 ± 1.5) and (28.8 ± 0.5), respectively, thus the cognitive function recovery of group B was faster than that of group A (P<0.01);The incidence of cognitive dysfunction was 8.89%(4/45) and 7.84%(4/51)in A group and B group af-ter extubation, and the difference was not statistically significant (P>0.05). Conclusion Compared with the combined in-travenous-inhalational anesthesia, the total intravenous anesthesia maintenance imposes less impact on the postoperative cognitive function in elderly cancer patients, with faster recovery, which is clinically applicable.