七氟烷吸入麻醉对老年肿瘤患者认知功能的影响

目的观察七氟烷吸入麻醉对老年肿瘤患者手术后认知功能的影响,为临床合理选择麻醉方法和麻醉药物提供参考。方法选择2008年2月至2010年12月我院收治的老年肿瘤手术患者126例,随机分为对照组和观察组各63例。对照组患者麻醉诱导后静脉靶控输注2～4μg/ml丙泊酚维持麻醉,观察组患者麻醉诱导后给予吸入1.0%～3.0%七氟烷维持麻醉。麻醉深度维持脑电双频指数(BIS)45～55;血压、心率控制在基础值的±20%以内。观察患者麻醉恢复过程,于麻醉前、应答后1 h、3 h、6 h、24 h采用简易精神状态量表(MMSE)评价患者的认知功能。结果两组患者应答后1 h、3 h时MMSE评分较麻醉前明显降低,差异有统计学意义(P<0.05);对照组患者应答后6h时MMSE评分与麻醉前MMSE评分比较,差异无统计学意义(P>0.05);观察组患者应答后6h时MMSE评分明显低于麻醉前MMSE评分,差异有统计学意义(P<0.05);两组患者应答后24 h时MMSE评分与麻醉前MMSE评分比较,差异无统计学意义(P>0.05)。提示对照组患者认知功能术后6 h时恢复至麻醉前水平;观察组术后24 h时恢复至麻醉前水平。结论丙泊酚静脉麻醉和七氟烷吸入麻醉均可引起老年肿瘤患者术后短期认知功能下降,并具有可逆性。七氟烷吸入麻醉患者认知功能的恢复时间较丙泊酚长。

The influence of sevofluen anesthesia in elderly patients with cancer of cognitive function after surgery for clinical anesthesia

Objective Observation of sevoflurane anesthesia in elderly patients with cancer of cognitive function after surgery for clinical anesthesia and narcotic drugs selected to provide reference.Method Select February 2008-February 2010 in our hospital 126 cases of elderly patients with tumors were randomly divided into control group and observation group of 63 cases.The control group after induction of anesthesia in patients with TCI 2-4 μg/ml and anesthesia was maintained with propofole,and the observation group after induction of anesthesia in patients given 1.0 to 3.0% inhaled sevoflurane to maintain anesthesia.Depth of anesthesia to maintain dual-band EEG index（BIS）45~55;blood pressure,heart rate control in the basic value within 20%.Observed in patients during anesthesia,before anesthesia,after answering 1 h,3 h,6 h,24 h using Mini Mental State Examination（MMSE）evaluated cognitive function in patients.Result After answering the two groups were 1 h,3 h when the MMSE score significantly lower than that before anesthesia,the difference was statistically significant（P0.05）;the control group after 6 h,response in patients with MMSE scores and MMSE scores before anesthesia,the difference was not statistically significant（P0.05）;The patients response after 6 h,MMSE scores were significantly lower MMSE scores before anesthesia,the difference was statistically significant（P0.05）;two groups of patients when the response 24 h after the MMSE score and MMSE score before anesthesia,the difference Not statistically significant（P 0.05）.Tip of cognitive function in patients with the control group after 6 h,recovered to the level before anesthesia;observation group after 24 h,recovered to the level before anesthesia.Conclusion Propofole intravenous anesthesia and sevoflurane inhalation anesthesia with elderly cancer patients bath can cause short-term cognitive decline and reversible.Patient′s recovery time with seveoflution inhalation anesthesia in cognitive function is longer than with propofole intravenous anesthesia.