不同的全身麻醉方式对行消化道肿瘤腹腔镜手术的老年患者术后早期认知功能的影响

目的探讨不同的全身麻醉方式对行消化道肿瘤腹腔镜手术的老年患者术后早期认知功能的影响。方法选取消化道肿瘤老年患者120例,按随机数字法分为A组、B组、C组,每组40例。A组给予异丙酚静脉麻醉,B组给予七氟醚吸入麻醉,C组给予七氟醚与异丙酚复合麻醉。结果C组术毕时、术后6 h、术后24 h、术后48 h的血清NSE、S100β水平明显高于A组、B组,差异有统计学意义(P<0.05)。C组术毕时、术后6 h、术后24 h、术后48 h的MMSE得分明显低于A组、B组,差异有统计学意义(P<0.05)。C组术毕时、术后6 h、术后24 h、术后48 h的POCD发生率明显高于A组、B组,差异有统计学意义(P<0.05)。结论七氟醚和异丙酚单药全身麻醉均可降低消化道肿瘤老年患者术后早期认知功能的影响,且可改善患者的血清NSE与S100B蛋白水平,减少术后POCD的发生。

Effects of Different General Anesthesia Methods on Early Cognitive Function of Elderly Patients with Digestive Tract Tumors after Laparoscopic Surgery

Objective To discuss the effects of different general anesthesia methods on early cognitive function of elderly patients with digestive tract tumors after laparoscopic surgery.Methods 120 elderly patients with digestive tract tumors were selected.According to the random distribution,all patients were divided into group A,group B and group C.Each group had 40 cases.Group A was given propofol intravenous anesthesia,group B was given sevoflurane inhalation anesthesia,and group C was given sevoflurane and propofol combined anesthesia.Results Serum NSE and S100 levels in group C were significantly higher than those of group A and group B at the end of surgery,6 h after surgery,24 h after surgery and 48 h after surgery,the difference was statistically significant(P<0.05).MMSE scores of group C at the time of completion,6 h,24 h and 48 h after surgery were significantly lower than those of group A and group B,the difference was statistically significant(P<0.05).The POCD incidence of group C at the time of completion,6 h,24 h and 48 h after operation was significantly higher than that of group A and group B,the difference was statistically significant(P<0.05).Conclusion Sevoflurane and propofol under general anesthesia can reduce the effects of early postoperative cognitive function in elderly patients with digestive tract tumors.Serum NSE and S100B proteins of the patients can be improved,and postoperative POCD can be reduced,it's worthy of further clinical promotion.