摘要
目的:观察七氟烷复合丙泊酚吸入时长对乳腺癌根治术患者术后认知功能的影响。方法:选取2016年8月至2019年8月在我院外科进行手术的104例乳腺癌患者,根据简单随机分组分为观察组与对照组,各52例。两组均给予低流量吸入七氟醚及泵注丙泊酚进行麻醉维持,同时持续静脉泵注瑞芬太尼进行镇痛。对照组吸入2h后停止吸入七氟醚,仅用泵注丙泊酚进行麻醉维持,两组患者均于手术缝皮时停用所有麻醉药物,并给予氧气供给。观察两组患者连接脑电双频指数(BIS)监测仪(T0)、麻醉诱导3min后(T1)、插管1min后(T2)、切皮1min后(T3)、缝皮1min后(T4)时BIS指数,对比两组患者术后自主呼吸恢复时间、睁眼时间、拔管时间及可进行语言陈述时间,对比两组患者手术前及手术1~12h后蒙特利尔认知量表(MoCA)评分,对比两组患者术后低血压、呕吐、支气管痉挛、心动过速等不良反应发生率。结果:两组年龄、BMI指数、汉族、少数民族比例、TNMⅡ期、Ⅲ期对比均无显著性差异,均有P>0.05。两组患者BIS指数均随时间变化的趋势并且时间因素的作用随着分组的不同而不同,P<0.05;两组患者术中各时点(T1、T2、T3、T4)BIS指数均显著降低,P<0.05;同时点比较,两组T0、T1、T2、T3比较差异无统计学意义,P>0.05,观察组T4时BIS指数显著高于对照组,P<0.05。观察组自主呼吸恢复时间、睁眼时间、拔管时间、可语言陈述时间均显著短于对照组,均有P<0.05。两组患者MoCA评分均随时间变化的趋势并且时间因素的作用随着分组的不同而不同,P<0.05;两组患者术后各时点(术后1h、术后6h、术后12h)MoCA评分较术前降低,P<0.05;同时点比较,观察组术后1h、术后6h、术后12h MoCA评分显著高于对照组,均有P<0.05。观察组术后不良反应总发生率较对照组无显著差异,P>0.05。结论:乳腺癌根治术全程吸入七氟烷进行麻醉,对乳腺癌患者认知功
Objective:To observe the effect of sevoflurane combined with propofol inhalation duration on postoperative cognitive function in patients with radical mastectomy.Methods:104 cases of breast cancer patients who underwent surgery in our hospital from August 2016 to August 2019 were selected and randomly divided into observation group and control group,52 cases in each group.Both groups were given low-flow inhaled sevoflurane and pump propofol for anesthesia maintenance,while continuous intravenous infusion of remifentanil for analgesia.In the control group,sevoflurane was stopped after inhalation for 2h and only pumped propofol was used for anesthesia maintenance.In both groups,all anesthetic drugs were stopped at the time of surgical suture and oxygen supply was given.Observed two groups of patients with connecting electrical double frequency index(BIS)monitor(T0),3 min after anesthesia induction(T1),1 min after intubation(T2),cut skin(T3),sewing leather after 1 min after 1 min(T4)BIS index,compared two groups of patients with postoperative spontaneous breathing recovery time,open time,extubation time and language can be stated time,compared two groups of patients before and after 1~12h operation,Montreal cognitive scale(MoCA)score,compared two groups of patients with postoperative hypotension,vomiting,bronchospasm,incidence of adverse reactions such as tachycardia.Results:There was no significant difference in body mass index(BMI),male proportion and man proportion between the two groups,all with P>0.05.The BIS index of two groups of patients changed with time,and the role of time factors varied with different groups,P<0.05;the BIS index at each time pant(T1,T2,T3,T4)in the two groups were significantly decreased,P<0.05;At the same time,there was no significantly difference in T0,T1,T2,T3 between the two groups(P>0.05).The BISindex at T4 in the observation group was significantly higher than that in the control group(P<0.05).The recovery time of spontaneous breathing,eye opening time,extubation time and verbal st
作者
崔德壮
房亮
冯春林
CUI Dezhuang;FANG Liang;FENG Chunlin(The First Hospital of Zibo City, Shandong Zibo 255200, China)
出处
《河北医学》
CAS
2021年第4期700-704,共5页
Hebei Medicine
基金
山东省医药卫生科技发展计划项目,(编号:2018WS0427)。
关键词
乳腺癌
乳腺癌根治术
七氟烷
丙泊酚
认知功能
Breast cancer
Radical mastectomy
Sevoflurane
Propofol
Cognitive function
