摘要
目的：观察瑞芬太尼对学龄儿童术后认知功能的影响。方法选取在本院行择期扁桃体或腺样体切除术且符合病例入组标准的患儿50例，术中采用瑞芬太尼0．1μg／kg／min 进行维持麻醉，分别于术前1 d ，术后1 d 、3 d 、7 d 分别对患儿的认知功能进行评价。结果与术前1 d 比较，术后1 d 患儿的认知功能评分显著下降（P ≤0．05）、认知功能障碍（POCD）发生率显著上升（P≤0．05）、POCD 各项指标（定向力、记忆力、注意力及计算力、回忆力、语言能力）评分均显著下降（P≤0．05）；术后3 d 部分指标（POCD 发生率、记忆力、注意力及计算力、语言功能）开始恢复正常（P≥0．05），但仍有部分指标（认知功能评分、回忆力、定向力）与术前1 d 比较具有显著性差异（P ≤0．05）；术后7d 所有指标与术前1 d 比较无显著性差异。结论学龄儿童经瑞芬太尼全身麻醉后，短期内存在POCD 症状，维持时间大概在3 d 左右，7 d 左右可恢复正常。
Objective To observe the influence remifentanil on postoperative cognitive function in school‐age children .Methods 50 school‐age children suffered elective tonsillectomy or adenoidectomy and in accordance with the inclusion criteria in our hospital were choiced ,and remifentanil 0 .1μg / kg / min was infused to maintain anesthesia in surgery .Cognitive function were evaluated respectively for children at preoperative 1d ,postoperative 1 d ,3 d and 7 d .Results The cognitive function score in children after surgery decreased significantly （P ≤ 0 .05） ,the cognitive dysfunction （POCD） incidence increased significantly （P ≤ 0 .05） ,and the scores of POCD Indicators （disorientation , memory ,attention and calculation ability ,recalls force ,language function） were significantly decreased （P ≤ 0 .05） at postoperative 1 d compared with preoperative 1 d .Some indicators （POCD incidence ,memory ,attention and calcula‐tion ability ,language function） returning to normal （P ≥ 0 .05） ,but there are still some indicators （cognitive func‐tion ,recalls force ,disorientation） with a significant difference to preoperative 1 d（P ≤ 0 .05） at postoperative 3d .All indicators showed no difference between preoperative 1d and postoperative 7 d .Conclusion School‐age children suf‐fered remifentanil anesthesia had obvious POCD symptoms in the short term ,which continued about three days ,and the POCD symptoms would disappear after 7 days .
出处
《检验医学与临床》
CAS
2015年第A02期127-129,共3页
Laboratory Medicine and Clinic
关键词
瑞芬太尼
学龄儿童
术后认知功能障碍
remifentanil
school-age children
postoperative cognitive dysfunction
