七氟烷吸入麻醉对高龄肝癌患者术后认知功能及苏醒质量的影响

Effect of sevoflurane inhalation anesthesia on postoperative cognitive function and recovery quality in elderly patients with liver cancer

探讨七氟烷吸入麻醉对高龄肝癌患者术后认知功能及苏醒质量的影响。方法将105例肝癌患者按随机数字表法分为观察组与对照组各50例,两组均给予瑞芬太尼,观察组联合七氟烷吸入麻醉,对照组联合丙泊酚麻醉。比较两组苏醒时间、拔管时间、警觉镇静评分量表评分及手术前后简易精神状态评定量表评分。结果观察组苏醒时间及拔管时间均显著早于对照组(P<0.05或0.01),拔管即刻警觉镇静评分量表评分显著高于对照组(P<0.05),拔管后60 min两组评分比较差异无统计学意义(P>0.05)。观察组术前、术后6 h、术后12 h简明精神状态评定量表评分比较差异无统计学意义(P>0.05),术后6 h观察组评分显著高于对照组(P<0.05);对照组术后6 h评分显著低于术前和术后12 h(P<0.05)。结论七氟烷吸入麻醉对高龄肝癌手术患者认知功能影响较小,术后苏醒质量高,值得临床推广应用。

Objective To investigate the effect of sevoflurane inhalation anesthesia on postoperative cognitive function and recovery quality in elderly patients with liver cancer.Methods 105 patients with liver cancer were randomly divided into observation group and control group,50 cases in each group.Remifentanil was given to both groups,the observation group was combined with sevoflurane inhalation anesthesia,and the control group was combined with propofoi anesthesia.The awakening time,extubation time, alertness sedation rating scale and MMSE scale before and after surgery were compared between the two groups.Results The awakening time and extubation time of the observation group were significantly shorter than those of the control group (P<0.05 or 0.01),immediately after extubation,the OAAS score was significantly higher than that of the control group (P<0.05).There was no significant difference in the scores between the two groups after 60 minutes of extubation (P>0.05).There was no significant difference in MMSE scores in the observation group before surgery,6 h after surgery and 12 h after surgery (P>0.05).The MMSE score of the observation group was significantly higher than that of the control group at 6 h after operation (P<0.05).In the control group,the score at 6 h after operation was significantly lower than that before surgery and 12 h after surgery (P<0.05).Conclusion Sevoflurane inhalation anesthesia has little effect on cognitive function in elderly patients with liver cancer surgery,and the quality of postoperative recovery is high,which is worthy of clinical application.