丙泊酚与气体麻醉对患者术后认知功能障碍影响分析

Effect of Propofol and Gaseous Anesthesia on Postoperative Cognitive Dysfunction of Patients

目的探析丙泊酚与气体麻醉对患者术后认知功能障碍影响。方法选择2014年1月至2015年1月我院收治97例符合标准的手术患者为研究对象。随机分为A组(49例)与B组(48例)。两组均静脉滴注芬太尼、依托咪酯、维库溴铵、咪达唑仑进行麻醉诱导。A组采用丙泊酚维持麻醉,B组吸入七氟烷维持麻醉。比较两组手术前后MMSE评分和血清S100β蛋白水平。结果两组术后1 h、3 h、6 h的MMSE评分均显著降低,且A组术后各时间点MMSE评分均高于B组,差异均具有统计学意义(P<0.05)。两组术后10 min血清S100β蛋白水平与诱导前相比均显著升高,术后24 h A组血清S100β蛋白水平开始降低,接近诱导前水平,B组继续升高,高于A组的同时也高于诱导前水平(P<0.05)。A组认知功能障碍发生率为2.0%,低于B组16.7%,差异具有统计学意义(P<0.05)。结论丙泊酚对患者神经系统损伤比七氟烷更轻,术后认知功能更快恢复,术后出现认知功能障碍风险因此得以降低,具有较大应用价值。

Objective To explore the effect of propofol and gaseous anesthesia on cognitive dysfunction of patients after surgery. Methods 97 cases of surgical patients met the standards and treated in our hospital from January 2014 to January 2015 were selected and randomly divided into group A （49 cases） and group B （48 cases）. Both groups were given fentanyl, etomidate, vecuronium and midazolam by intravenous infusion for anesthesia induction, group A was given propofol for maintained anesthesia, group B was given inhaled sevoflurane for maintained anesthesia. The scores of MMSE and level of serum S100β protein before and after surgery were compared between the two groups. Results The MMSE scores of the two groups after 1 h, 3 h and 6 h of the surgery decreased significantly, and the MMSE score of group A after surgery was higher than that of group B, with statistical difference （P 〈0.05）. The levels of serum S100βprotein of the two groups after 10 min of the surgery increased significantly;after 24 h of the surgery, the level of serum S100βprotein of group A decreased, and was closed to the level before induction, while the level of group B continued to increase, and higher than that of group A and that before induction （P〈0.05）. The incidence of POCD of group A was 2.0%, significantly lower than 16.7%of group B, with statistical difference （P 〈0.05）. Conclusions Propofol has lighter damage on patients＇ nervous system than sevoflurane, with patients＇ cognitive function recovering faster after surgery so that the risk for cognitive dysfunction after surgery can be reduced, which is of great application value.