不同全身麻醉方法对老年患者术后认知功能的影响

Comparison of different general anesthesia method on preoperation cognitive function in elderly patients

目的 比较不同全身麻醉（全麻）方法对老年患者术后认知功能的影响.方法 选取行非心脏外科手术的老年患者82例,按照数字表法随机分为两组,每组41例.A组采用苏芬太尼联合丙泊酚静脉注射全麻,B组采用七氟烷吸入全麻.两组于术前、术后3h、6h、24 h采用简易智力量表（MMSE）评价患者的认知功能,同时评价患者术后恢复的各项指标.结果 A组患者术后睡眠时间为（6.9±1.2）min,语言能力恢复时间为（9.8±2.2） min,均长于B组（t=6.687、5.640,均P＜0.01）.A组患者术后3h、6h、24 h MMSE评分分别为（17.1±2.2）分、（19.6±2.7）分、（22.4±2.3）分,均低于B组（t=10.026、6.229、5.082,均P＜0.01）.A组术后24 h认知功能障碍发生率为36.6％,显著高于B组的17.1％ （Х^2 =3.98,P＜0.05）.结论 采用吸入麻醉方法的患者术后恢复较快,认知功能障碍发生率低,临床效果更好.

Objective To compare the effect of different general anesthesia method on preoperation cognitive function in elderly patients.Methods According to the digital table,82 elderly patients（non cardiac surgical operation） were selected and divided into the two groups,each group 41 cases.The group A was given to sufentanil combined with propofol intravenous injection anesthesia,and the group B was given to sevoflurane inhalation anesthesia.The cognitive function of patients of two groups in preoperative,postoperative 3h,6h,24h were assessed by simple intelligence scale（MMSE）,and the indicators of postoperative recovery were evaluated.Results The postoperative sleep time [（6.9 ± 1.2） min],language ability recovery time [（9.8 ± 2.2） min] in the group A were all higher than those of group B （t =6.687,5.640,all P 〈 0.01）.The MMSE scores in group A after 3h [（17.1 ± 2.2） points],6h [（19.6 ±2.7）points],24h[（22.4 ±2.3） points] were lower than those of group B（t =10.026,6.229,5.082,all P〈0.01）.And the PCOD rate in group A after 24h was 36.6%,which was higher than 17.1% in group B（Х^2 =3.98,P 〈 0.05）.Conclusion The inhalational anesthetic methods has more quickly postoperative recovery,lower incidence of cognitive dysfunction,better clinical effects.