门诊全身麻醉下胃肠镜检查术对成人不同年龄患者认知功能的影响

The influence of outpatient gastrointestinal endoscopy under general anesthesia on postoperative cognitive function in adult patients of different ages

目的观察门诊无痛胃肠镜丙泊酚麻醉后及离院时患者认知功能的恢复情况,探讨年龄对门诊麻醉后认知恢复与安全的影响。方法选择门诊拟行无痛胃肠检查,根据不同年龄(20~79岁)分为I^VI 6组,每组30人,共180人。应用警觉镇静评分及简易智能精神测量表对丙泊酚麻醉下行无痛胃肠镜检查后的麻醉清醒时间、离院时间、认知功能恢复时间及程度进行观察与评估。结果所有年龄段患者麻醉后警觉镇静评分达5分时,记忆力及回忆力明显受抑制;在离院时,所有年龄段患者的记忆力完全恢复,但70岁以上患者的注意力与计算力仍受抑制;I^VI组患者结束麻醉后离院的时间逐渐延长。40岁以后各组患者自觉认知功能行为功能完全恢复时间大于实际离院时间。结论丙泊酚麻醉行无痛胃肠镜检查和治疗后认知功能部分受抑制;40岁以上患者应适当延长离院时间至其认知功能完全恢复。

【Objective】To observe the rehabilitation of cognitive function of outpatients painless gastrointestinal endoscopy after propofol general anesthesia and at disposition, then explore the effect of age on cognitive recovery and security after ambulatory anesthesia.【Methods】One hundred and eighty patients selected for gastrosocpy were divided into group Ⅰ to Ⅵ（20-79 years old）（n =30）. The alert sedation score and mini-mental state examination was used to record and evaluate the awaking time of general anesthesia, hours of discharge hospital, the time and degree of rehabilitation of cognitive function. 【Results】When alert sedation score was 5, the ability of memory and recall was restrained. But when the patients discharged the hospital, the memory ability was completely recovered in all age groups. The 70-79 years old patient＇s ability of attention and calculation were not full-recovery when they left hospital. The time of leaving hospital in groups Ⅰ -Ⅵ was gradually extend. The fully conscious cognitive behavior function recovery time was actually longer than discharge time of patients older than 40 years. 【Conclusion】The cognitive function was partly restrained by propofol general anesthesia for painless gastrointestinal. Over 40 years old patients should be appropriately extended from the court to recover fully to its cognitive function.