硬膜外阻滞对老年全身麻醉下腹腔镜结肠癌根治术后认知功能的影响

Effect of Epidural Block on Postoperative Cognitive Function in Elderly Patients With Colon Cancer After Laparoscopic Surgery Under General Anesthesia

目的探讨全身麻醉联合硬膜外阻滞对老年患者腹腔镜结肠癌根治术后认知功能(POCD)的影响。方法选择南阳市第一人民医院行腹腔镜结肠癌根治术的老年患者120例,将以上患者均分为观察组和对照组,对照组行常规全身麻醉,观察组行硬膜外阻滞复合全身麻醉,使用简易精神状态量表(MMSE)评价认知功能。结果两组麻醉后自主呼吸恢复时间、苏醒时间、拔管时间差异无统计学意义(P>0.05),术后第1 d、第3 d MMSE评分两组均出现显著的减低(P<0.05),观察组均高于对照组(P<0.05),术后第1 d、第3 d对照组认知功能障碍(POCD)发生率均高于观察组(P<0.05)。结论全麻联合硬膜外阻滞对腹腔镜下结肠癌根治术老年患者认知功能影响小,可降低POCD发生,具有一定的临床应用价值。

Objective To explore the effect of general anesthesia combined with epidural anesthesia on postoperative cognitive dysfunction （POCD） in elderly colon cancer patient underwent laparoscopic radical operation. Methods 120 cases of elderly patients underwent laparoscopic radical colon cancer operation were selected in the First People＇s Hospital of Nanyang City, they were randomly divided into two groups of equal number, and were recorded as the observation group and the control group, the control group were anesthetized with conventional general anesthesia, and the observation group were anesthetized with general anesthesia combined with epidural anesthesia observation, the cognitive function was estimated by MMSE. ResultsThe recovery time of respiratory depression, drowsiness and extubation was no signiifcant differences between the two groups （P〉0.05）, The MMSE score of first days and third days after operation was decreased （P〈0.05）. The observation group was higher than that in the control group （P〈0.05）, the incidence of cognitive dysfunction （POCD） in the control group was higher than that in the observation group after ifrst days and third days after operation （P〈0.05）.Conclusion The general anesthesia combined with epidural anesthesia can decrease POCD in elderly colon cancer patient underwent laparoscopic radical operation, with worthy of clinical application.