摘要
目的探讨闭环靶控输注下不同麻醉深度对老年全身麻醉患者术中血流动力学及术后认知功能障碍的影响。方法选取2019年3月至2020年12月在徐州医科大学附属医院行择期全身麻醉手术的老年患者80例,按照随机数字表法分成观察组(40例)和对照组(40例)。对照组在闭环靶控输注下设置脑电双频指数(BIS)为45进行全身麻醉,观察组在闭环靶控输注下设置BIS为55进行全身麻醉,比较两组患者术中不同时间的血流动力学[插管后即刻(T_(1))、手术开始后20 min(T_(2))、手术开始后60 min(T_(3))、手术开始后100 min(T_(4))及拔出气管导管即刻(T_(5))]及术后不同时间认知功能障碍评估情况。结果观察组T_(2)、T_(3)、T_(4)时期心率(HR)高于本组T_(1)时期,差异有统计学意义(P<0.05);观察组T_(2)、T_(3)、T_(4)、T_(5)时期平均动脉压(MAP)高于本组T_(1)时期,差异有统计学意义(P<0.05);对照组T_(2)、T_(3)、T_(4)、T_(5)时期HR、MAP高于本组T_(1)时期,差异有统计学意义(P<0.05);观察组T_(1)、T_(3)、T_(5)时期HR低于同期对照组,差异有统计学意义(P<0.05);观察组T_(1)时期MAP高于同期对照组,差异有统计学意义(P<0.05);观察组T_(5)时期MAP低于同期对照组,差异有统计学意义(P<0.05);观察组术后1 d与术后2、3、7 d的简易智能精神状态检查量表(MMSE)评分比较,差异无统计学意义(P>0.05);对照组术后2、3、7 d的MMSE评分高于本组术后1 d,差异有统计学意义(P<0.05);观察组术后1、2 d的MMSE评分高于同期对照组,差异有统计学意义(P<0.05);两组术后3、7 d的MMSE评分比较,差异无统计学意义(P>0.05)。结论老年全身麻醉患者实施闭环靶控输注下深度麻醉,能够促进血流动力学的稳定,促进患者术后认知功能的恢复。
Objective To investigate the effects of different anesthesia depths under closed circle target-controlled infusion on intraoperative hemodynamics and postoperative cognitive dysfunction in elderly patients under general anesthesia.Methods Eighty elderly patients who underwent elective general anesthesia in Affiliated Hospital of Xuzhou Medical University from January 2018 to January 2021 were selected and divided into the observation group(40 cases)and the control group(40 cases)according to the random number table method.The control group was given general anesthesia with BIS 45 under closed target-controlled infusion.In the observation group,BIS was set at 55 under closed loop target controlled infusion for general anesthesia.Intraoperative hemodynamics at different times(Immediate after intubation[T_(1)],20 min[T_(2)]after the start of surgery,60 min[T_(3)]after the start of surgery,100 min after the start of surgery[T_(4)],and immediate extraction of the tracheal catheter[T_(5)])and postoperative cognitive dysfunction at different times were compared between the two groups.Results The heart rate(HR)of the observation group at T_(2),T_(3),T_(4) was higher than that at T_(1) in the group,with statistically significant difference(P<0.05).The mean arterial pressure(MAP)the observation group at T_(2),T_(3),T_(4),T_(5) was higher than that at T_(1) in the group,with statistically significant difference(P<0.05).The HR and MAP of the control group at T_(2),T_(3),T_(4),T_(5) were higher than those at T_(1) in the group,with statistically significant differences(P<0.05).The HR of the observation group at T_(1),T_(3),T_(5) was lower than that of the control group in the same period,with statistically significant difference(P<0.05).The MAP of the observation group at T_(1) was higher than that of the control group in the same period,with statistically significant difference(P<0.05).The MAP of the observation group at T_(5) was lower than that of the control group in the same period,with statistically significant differen
作者
倪林花
NI Lin-hua(Department of Anesthesiology,Affiliated Hospital of Xuzhou Medical University,Jiangsu Province,Xuzhou221000,China)
出处
《中国当代医药》
CAS
2021年第35期19-22,共4页
China Modern Medicine
关键词
闭环靶控输注
不同麻醉深度
全身麻醉
血流动力学
认知功能障碍
Closed-loop target-controlled infusion
Different depth of anesthesia
General anesthesia
Hemodynamics
Cognitive dysfunction
