摘要
目的探讨三种不同的全身麻醉药物使用方法对腹腔镜胆囊切除术后早期认知功能的影响。方法选取拟行腹腔镜胆囊切除手术的96例患者。根据麻醉药物使用方法的不同,分为A组(34例,注射咪达唑仑0.25 mg/kg、芬太尼4μg/kg、维库溴铵0.1 mg/kg)、B组(30例,注射丙泊酚2 mg/kg、芬太尼4μg/kg、维库溴铵0.1 mg/kg)、C组(32例,注射咪达唑仑0.05 mg/kg、丙泊酚1.5 mg/kg、芬太尼4μg/kg、维库溴铵0.1mg/kg)。分别于术前、术后对所有患者进行简易智力状态检查(MMSE)测试。结果与术前相比,A组患者术后1 d、3 d、5 d、7 d的MMSE评分下降显著,差异均有统计学意义(P<0.05);与术前相比,B组患者术后3 d、5 d的MMSE评分下降显著,差异均有统计学意义(P<0.05),但术后7 d后有恢复的趋势;与术前相比,C组患者术后1 d、3 d的MMSE评分下降显著,差异均有统计学意义(P<0.05),术后5 d、7 d差异无统计学意义。结论三种不同的麻醉药物使用方式对患者行腹腔镜胆囊切除术后的认知功能障碍均有不同程度的影响,以咪达唑仑联合芬太尼与维库溴铵麻醉的影响程度较大,影响持续时间也较长。但丙泊酚联合芬太尼与维库溴铵和丙泊酚、咪达唑仑联合芬太尼与维库溴铵麻醉患者的认知恢复功能快。
Objective To explore the affect of three general anesthetic methods on early cognitive function after laparoscopic cholecystectomy. Methods Ninety-six patients with laparoscopic cholecystectomy were selected from our hospital and divided into three groups according to the anesthetic method,including midazolam group （group A） propo-fol group （group B） ,midazolam and propofol group （group C）. All patients was tested by Mini-Mental State Examina-tion （MMSE） before and after operation. Results Compared with the preoperation, the MMSE score of 1 days,3 days, 5 days,7 days after operation were significantly decreased in group A （P 〈0. 0 5 ） . Compared with the preoperation, the MMSE score of 3 days,5 days after operation were significantly decreased in group B（P 〈0. 05） , these patients tended to recover after 7 days in group B. Compared with the preoperation, the MMSE score of 1 days, 3 days after operation were significantly decreased in group C（P 〈0. 05 ） . But the cognitive functional recovery is the fastest in patients with midazolam and propofol anesthesia. Conclusion Three different anesthesia methods have different affect on cognitive dysfunction of patients with laparoscopic cholecystectomy. The affect of midazolam intravenous anesthesia has a longer duration and a greater influence . But the cognitive functional recovery is the fastest in patients with midazolam and propofol anesthesia.
出处
《中国临床保健杂志》
CAS
2017年第2期155-157,共3页
Chinese Journal of Clinical Healthcare
基金
全军保健专项基金资助项目(14BJZ14)
关键词
胆囊切除术
腹腔镜
麻醉
全身
认知障碍
Cholecystectomy, laparoscopic
Anesthesia, general
Cognition disorders
