摘要
目的比较腹腔镜根治性前列腺切除术和开放根治性前列腺切除术对患者术后认知功能影响的程度。方法选取因前列腺癌行根治性前列腺切除术的患者188例,其中行腹腔镜手术86例(腹腔镜组),行开放手术102例(开放手术组)。两组患者均予全身麻醉,分别于术前1d、术后1d和术后1周采用简明精神状态检查表(MMSE)行神经精神功能评估,并分别行手术前后及组间比较。结果两组患者年龄、受教育时间、术前MMSE评分均无统计学差异(均P>0.05)。腹腔镜组术前和术后1d的时间地点定向力评分分别为(9.86±0.04)、(9.68±0.06)分,延迟记忆评分分别为(2.31±0.05)、(2.01±0.06)分,MMSE评分分别为(26.17±0.12)、(25.41±0.12)分,两组比较差异均有统计学意义(均P<0.05)。开放手术组术前和术后1d的时间地点定向力评分分别为(9.83±0.04)、(9.67±0.06)分,两者比较有统计学差异(P<0.05)。两组患者术后1周的MMSE各项评分与术前比较均无统计学差异(均P>0.05)。结论腹腔镜根治性前列腺切除术较开放根治性前列腺切除术更易引起患者一过性的术后认知功能下降或障碍,但长期比较无明显差异。
Objective To assess the postoperative cognitive function in patients with general anesthesia for laparoscopic or open radical prostatectomy. Methods One hundred and eighty eight prostate cancer patients underwent radical prostatecto- my under general anesthesia, among whom 86 received laparoscopic surgery and 102 received open surgery. Cognitive function was assessed one day and one week after surgery with MMSE score in two groups. Results There was no significant difference in age, education level, preoperative MMSE scores between two groups （all P 〉0.05）. In laparoscopy group, the temporal disorientation before and 1 day after operation was 9.86 ± 0.04 and 9.68 ± 0.06）, the delayed memory was 2.31± 0,05 and 2.01 ±0.06, the MMSE scores were 26.17±0. 12 and 25.41 ±0. 12, respectively（all P〈0.05）. In the open surgery group, the temporal disorientation before and 1 day after surgery was 9.83± 0.04 and 9.67 ±0.06, respectively（P〈0.05）. There were no significant differences in all indexes 1 week after operation between two groups （P〈0.05）. Conclusion Temporary postoperative cognitive dysfunction is more likely to develop after general anesthesia for laparoscopic radical prostatectomy than open radical prostatectomy, but there is no significant difference 1 week after surgery.
出处
《浙江医学》
CAS
2015年第21期1764-1766,共3页
Zhejiang Medical Journal
关键词
认知功能障碍
简明精神状态检查
腹腔镜
根治性前列腺切除术
Postoperative cognitive dysfunction （POCD） Mini-mental state examination （MMSE） Laparoscopy Radical prostatectomy
