摘要
目的比较不同麻醉方式刘普胸外科老年患者术后早期认知及中枢神经的影响。方法选择2012年10月至2014年5月老年普胸外科手术患者70例，将其随机分为A、B两组备35例，A组采用全身麻醉，B组采用联合麻醉（全身麻醉联合硬脊膜外腔阻滞麻醉）。分别在术前1d和术后的第1、3、7、28d使用简易智力状态检查法（MMSE）对患者的认知功能进行评估。分别在术前1d、手术结束时刻以及术后1d取患者的静脉血浆榆测NSE（神经元特异性烯醇化酶）质盛浓度以及S100β蛋白的表达水平，对患者的中枢神经系统的损伤情况进行评估。结果阿组患者的术前1d与术后28天的MMSE评分无差异，阿组患者的术后1、3、7dMMSE评分比同组的术前1d姥著降低．其中B组术后1、3、7dMMSE评分高于A组（P〈O．05）；A、B两组之间术前1dNSE质疑浓度、s100β蛋白的表达水平和术后ldNSE的浓度，尤显著差异（P〉0．05）。B组手术结束时、术后1d的s100β蛋白的表达水平和手术结束时NSE的质壤浓度娃著低于A组（P〈0．05），与同组的术前1d比较．有娃著的升高（P〈0．05）。结论对于老年患者的普胸外科手术，与单纯全身麻醉相比，应用全身麻醉联合硬脊膜外胎阻滞麻醉更有利于老年患者的早期认知功能的恢复，适合在临床推广应用。
Objective Comparison of different anesthesia methods on general thoracic surgery in elderly patients with early postop- erative cognitive and central nervous system. Methods October 2012 May 2014 general thoracic surgery in elderly patients 70 cases were randomly divided into A, B two groups of 35 cases, A group with general anesthesia, group B combined anesthesia （general anes- thesia comhmed with hard meninges external cavity anesthesia）, 1d, respectively, in the preoperative and postoperative first 1,3,7,28 d using the mini-n, ental state examination method （MMSE） for cognitive function in patients evaluated. Preoperatively 1d, surgery and postoperative ld end time taken to detect the patient＇s venous plasma NSE （neuron-specific enolase）, and the mass concentration of s100β protein expression levels of damage of the central nervous system of patients evaluated. Results There were preoperative and postoperative 1d 28 days no difference in MMSE score, after the two groups of patients 1,3,7 d MMSE score than the preoperative ld significantly reduced in the same group, where group B after 1,3, 7d MMSE score than group A （P〈0.05） ; concentration of a, pre- operative Bld NSE concentration between the two groups, and the protein expression levels s100β after 1 d NSE, and no significant difference （P〈0. 05）. Group B at the end of surgery, the expression level after 1 d of s100β protein and NSE concentration at the end of surgery was significantly lower than group A （P〈0.05）, ld comparison with the same group before surgery, a significant rise （P〈0.05）. Conclusion For general thoracic surgery in elderly patients, compared with general anesthesia alone, general anesthesia com- bined application of epidural anesthesia is more conducive to the early recovery of cognitive function in elderly patients, suitable for clin- ical application.
出处
《检验医学》
CAS
2016年第B11期32-33,共2页
Laboratory Medicine
关键词
麻醉
认知
中枢神经
Anesthesia
Cognition
Central nervous
