全身麻醉药物对老年患者术后早期认知功能障碍的影响

目的 探讨不同全身麻醉药物对老年患者术后早期认知功能障碍的影响.方法 选择我院2010年8月-2012年6月实施全身麻醉患者60例,随机分为3组,分别给予3组患者C泊酚、七氟醚及咪达唑仑维持麻醉,分析临床结果.结果 3组患者组间苏醒及拔管时间相比较,A组和C组比较差异无统计学意义（P＞0.05）,但B组却短于A组、C组,差异有统计学意义（P＜0.05）.3组患者麻醉前MoCA及MMSE评分差异均无统计学意义（P＞0.05）.与麻醉前相比,A、C两组患者麻醉后6h、1d及3d的MoCA及MMSE评分差异有统计学意义（P＜0.05）;B组麻醉前后MoCA及MMSE评分差异无统计学意义（P＞0.05）.同B组相比,其余两组麻醉后各时间点的MoCA及MMSE评分差异均有统计学意义（P＜0.05）.结论 3种麻醉药物在老年患者全身麻醉中均能保证安全高效的麻醉作用,其中七氟醚对患者术后早期认知功能障碍影响明显小于C泊酚及咪达唑仑,值得推广使用.

Effect of Early Postoperative Cognitive Dysfunction in Elderly Patients Caused by General Anesthesia Drugs

Objective To investigate the clinical efficacy of different anesthesia drugs on cognitive dysfunction early after surgery in the elderly patients. Methods 60 cases of patients with general anesthesia in our hospital from August 2010 to June 2012 were randomly divided into three groups, group A, group B, group C. Three groups were given propofol, sevoflu- rane and midazolam anesthesia maintenance in turn, to analyse the clinical efficacy of the three anesthesia drugs. Results The recovery time and extubation time of patients in group A were no significantly difference with patients＇in group C （P 〉 0. 05 ） ; The recovery time and extubation time of patients in group B were significantly shorter than patients＇in other groups （ P 〈 0. 05 ） ; MoCA and MMSE score before anesthesia of patients in three groups were no significantly difference （ P 〉 0. 05 ） . MoCA and MMSE score after anesthesia 6 hours, 1 days and 3 days of patients in group A and group C were significant difference （ P 〈 0. 05 ） ; The difference of MoCA and MMSE score before anesthesia and after anesthesia of patients in group B was no statistically significant （P 〈 0. 05） . Compared with group B, MoCA and MMSE score of patients in the other groups was significant differ- ence, B group was significantly better than the other two groups （ P 〈 0. 05 ）. Conclusion The three kinds of anesthetic drugs can guarantee safe and effective anesthetic effect for the elderly patients with general anesthesia. The effects of sevoflurane on early cognitive impairment of the elderly patients with general anesthesia was significantly less than with propofol and midazolam, is worthy to be popularized.