不同全身麻醉方法对腹腔镜胆囊切除术后早期认知功能影响

目的探讨不同全身麻醉方法在腹腔镜胆囊切除术后早期认知功能的影响。方法选取本溪市中心医院2012年3月至2015年2月收治的120例腹腔镜胆囊切除术患者为研究对象,随机分为3组,每组各40例患者。A组行咪达唑仑静脉复合麻醉,B组行丙泊酚静脉复合麻醉,C组行咪达唑仑与丙泊酚静脉复合吸入麻醉。对3组患者治疗前与治疗后不同时间点的认知功能得分进行评估并比较。结果 C组与B组的苏醒麻醉躁动发生率与低血压发生率、患者满意度等指标均优于A组,且C组也显著优于B组,差异均有统计学意义(P<0.05);A组术后24、48、72 h的认知功能评分均低于术前认知功能评分(P<0.05);B组术后24、48 h认知功能低于术前,而术后72 h认知功能恢复到与术前无明显差异(P>0.05);C组术后不同时间的认知功能评分与治疗前无明显差异(P>0.05)。结论丙泊酚静脉复合麻醉与咪达唑仑及丙泊酚静脉复合吸入麻醉均可改善术后认知功能障碍发生。

Impacts of different general anesthesia methods on early cognitive function after laparoscopic cholecystectomy

Objective To investigate the impacts of different anesthesia methods on early cognition function after laparoscopic chole-cystectomy. Methods A retrospective study was performed on 120 patients who received laparoscopic cholecystectomy in Benxi Cen-tral Hospital from March 2012 to February 2015. Patients were randomly divided into 3 groups with 40 cases in each group. Patients were given midazolam intravenous anesthesia in Group A,patients were given propofol intravenous anesthesia in Group B,and the oth-ers were given midazolam and propofol intravenous combined inhalation anesthesia in Group C. The cognitive function scores of patients in the three groups before and after treatment at different time points were evaluated. Results The incidence of awake anesthesia rest-lessness and hypotension,and patients satisfaction rate in Group B and Group C were better than those in Group A,the clinical index in Group C was significantly better than that in Group B,and the differences were statistically significant(P<0. 05);the postoperatively cognitive function scores in 24 hours,48 hours and 72 hours were all lower than the preoperative scores in Group A(P<0. 05);the postoperatively cognitive function scores in 24 hours,48 hours were both lower than the preoperative scores,and the postoperative re-covery of cognitive function in 72 hours had no significant difference with the preoperative cognitive function in Group B(P>0. 05);the postoperatively cognitive function scores at different times had no significant difference compared with preoperative scores in Group C(P>0. 05). Conclusion Either propofol intravenous anesthesia or midazolam and propofol intravenous combined inhalation anes-thesia can improve postoperatively cognitive dysfunction.