摘要
目的比较七氟烷与异丙酚对老年患者局部脑氧饱和度及术后早期认知功能的影响。方法选择于胸腔镜下行肺癌根治术的患者60例，男女不限，年龄65—75岁，美国麻醉医师协会（ASA）分级Ⅰ-Ⅱ级，采用随机数字表法将患者随机分为2组：七氟烷组（S组）与异丙酚组（P组）。2组患者均于入室后持续监测局部脑氧饱和度直至拔管，分别于术前1d及术后7d进行神经心理学测试，评价患者认知功能，根据Z计分法计算术后认知功能障碍发生率。结果2组患者单肺通气期间均发生局部脑氧饱和度降低。2组患者术后认知功能障碍发生率无统计学差异，但与P组比较，术后7dS组简易精神状态评价量表（MMSE）评分、数字广度测试（顺背和逆背）评分、词汇流畅性测试评分降低（P〈0．05）。结论七氟烷复合麻醉与异丙酚复合麻醉对单肺通气期间局部脑氧饱和度的影响无统计学差异；S组术后7d认知功能较P组有所降低（P〈0．05）。
Objective To compare the regional cerebral oxygen saturation and early postoperative cognitive dysfunction in elderly patients under- going sevoflumne-based anesthesia versus propofol-based anesthesia. Methods Sixty patients of both genders, aged 65-75 yr, ASA physical sta- tus Ⅰ to Ⅱ, were randomly allocated to either sevoflurane-based anesthesia group （group S ,n = 30） or propofol-based anesthesia group （group P, n =30）. Cerebral oximeter was used to measure regional cerebral oxygen saturation （rSO2） from the awake state to extubation. At 1 day before op- eration and 7 days after operation, cognitive dysfunction was assessed by a battery of six neuropsychological tests, and the scores were recorded. Re- suits There were significant decrease of rSO2 in both groups. The total incidence of POCD showed no differences between the two groups. Com- pared to group P, mini-mental state examination scores, digit-span test （foreward and backward） scores and word recognition test scores were sig- nificantly decreased at 7 days after operation in group S. Conclusion There was no significant difference in rSO2 under sevoflurane-based anesthe- sia versus propofol-based anesthesia, postoperative cognitive function was decreased under sevoflurane-based anesthesia when compared with that under propofol-based anesthesia in the elderly patients.
出处
《中国医科大学学报》
CAS
CSCD
北大核心
2016年第9期797-800,817,共5页
Journal of China Medical University
基金
辽宁省自然科学基金(2014021023)
关键词
术后认知功能障碍
异丙酚
七氟烷
局部脑氧饱和度
麻醉
postoperative cognitive dysfunction
propofol
sevoflurane
regional cerebral oxygen saturation
anesthesia
