摘要
目的分析全麻腹腔镜手术对老年腹部手术患者血流动力学、镇静效果及认知功能的影响。方法以2020年1月-2022年6月于新干县人民医院行腹部手术治疗的66例老年患者为研究对象,采用随机数字表法分为A组(33例)与B组(33例)。两组均接受全麻腹腔镜手术治疗,A组选择全凭静脉全麻,B组采用静吸复合全麻,比较两组麻醉前(T0)、全麻诱导插管后(T1)、气腹建立后60 min(T2)、苏醒后(T3)的血流动力学指标[平均动脉压(MAP)、血氧饱和度(SpO_(2))、心率(HR)]、镇静效果(麻醉起效时间、Ramsay镇静评分)、苏醒时间(自主呼吸恢复时间、睁眼时间、拔管时间、定向力恢复时间)、认知功能[简易精神状态检查量表(MMSE)评分]及不良反应。结果两组T1、T2时点MAP、SpO_(2)水平低于T0时点,HR高于T0时点,但A组T1、T2时点MAP、SpO_(2)水平高于B组,HR低于B组,差异有统计学意义(P<0.05)。A组麻醉起效时间短于B组(P<0.05),但两组Ramsay镇静评分比较,差异无统计学意义(P>0.05)。A组自主呼吸恢复时间、睁眼时间、拔管时间、定向力恢复时间短于B组(P<0.05)。两组术后24h的MMSE评分低于术前,但A组MMSE评分高于B组(P<0.05),而两组术后72 h的MMSE评分比较,差异无统计学意义(P>0.05)。A组不良反应发生率小于B组(P<0.05)。结论全麻腹腔镜手术在老年腹部手术患者中具有较高可行性,其中全凭静脉全麻与静吸复合全麻均具有良好镇静效果,但前者对患者血流动力学及认知功能的影响更小,麻醉起效时间及苏醒时间更短,不良反应更少,更适用于老年患者。
Objective To analyze the effects of general anesthesia laparoscopic surgery on hemodynamics,sedation and cognitive function in elderly patients undergoing abdominal surgery.Methods A total of 66 elderly patients who underwent abdominal surgery in Xingan County People's Hospital from January 2020 to June 2022 were selected as the research objects,and they were divided into group A(33 patients)and group B(33 patients)by random number table method.Both groups received laparoscopic surgery under general anesthesia.Group A received total intravenous anesthesia,and group B received combined intravenous and inhalation anesthesia.The hemodynamic indexes[mean arterial pressure(MAP),oxygen saturation(SpO_(2)),heart rate(HR)]before anesthesia(T0),after general anesthesia induction and intubation(T1),60 min after pneumoperitoneum establishment(T2),and after recovery(T3),sedative effect(onset time of anesthesia,Ramsay sedation score),recovery time(spontaneous breathing recovery time,eye opening time,extubation time,orientation recovery time),cognitive function[Mini-mental State Examination(MMSE)score]and adverse reactions were compared between the two groups.Results The levels of MAP and SpO_(2)at T1 and T2 in the two groups were lower than those at T0,and HR was higher than that at T0,but the levels of MAP and SpO_(2)at T1 and T2 in group A were higher than those in group B,and HR was lower than that in group B,the differences were statistically significant(P<0.05).The onset time of anesthesia in group A was shorter than that in group B(P<0.05),but there was no significant difference in Ramsay sedation score between the two groups(P>0.05).The spontaneous breathing recovery time,eye opening time,extubation time and orientation recovery time in group A were shorter than those in group B(P<0.05).The MMSE score of the two groups at 24 h after operation was lower than that before operation,but the MMSE score of group A was higher than that of group B(P<0.05),while there was no significant difference in MMSE score between the two
作者
孙强
佘丽丽
黄敏红
SUN Qiang;SHE Li-li;HUANG Min-hong(General Surgery Department of Xingan County People's Hospital,Xingan 331300,Jiangxi,China)
出处
《医学信息》
2023年第23期46-49,共4页
Journal of Medical Information
关键词
腹部手术
老年患者
全身麻醉
腹腔镜手术
血流动力学
镇静效果
认知功能
Abdominal surgery
Elderly patients
General anesthesia
Laparoscopic surgery
Hemodynamics
Sedative effect
Cognitive function
