七氟烷联合瑞芬太尼对麻醉后认知功能影响

Effect of sevoflurane combined remifentanil on cognitive function after anesthesia

目的探析七氟烷联合瑞芬太尼对于患者麻醉后认知功能的影响。方法选取2013年11月-2014年11月我院的86例外科需进行全身麻醉的患者为研究对象,随机分为联合组和常规组,联合组43例患者,行七氟烷联合瑞芬太尼麻醉方法,常规组43例患者,行单纯瑞芬太尼麻醉,分析对比两组患者手术前、后MMSE评分以及基本生命状态等。结果联合组与常规组患者在术前24h的MMSE评分无统计学意义（P〉0.05）,术后24、72、48h、以及1周,联合组患者的MMSE评分均低于对照组,差异有统计学意义（P〈0.05）,且术后1周,联合组患者的MMSE评分更趋于术前状态。两组患者术后睁眼时间无统计学意义（P〉0.05）,联合组的患者术后拔管时间以及语言应答时间均早于对照组（P〈0.05）。结论七氟烷联合瑞芬太尼相对于单纯使用瑞芬太尼的麻醉方式能够有效降低患者术后认知功能障碍的发生率,使患者术后短时间内恢复正常生命体征,拔管时间更短,苏醒更快。

Objective To explore and analyze the effect of sevoflurane combined remifentanil on patients＇ cognitive function after anesthesia. Methods 86 patients, who were carried on general anesthesia in surgical department of our hospital from November 2013 to November 2014,were selected as the research objects,and were randomly divided into combination group and routine treatment group.43 patients in combination group were treated with the anesthesia method of sevoflurane combined remifentanil,while 43 patients in routine treatment group were treated with the anesthesia method of simple remifentanil.To comparatively analyze the MMSE score and basic life state etc. before and after operation of the two groups. Results The differences of MMSE score of patients 24 h before operation between the two groups was no statistical significance（P〉0.05）,while which of patients 24,72,48 h,1w after operation in combination group were lower than wihch in routine treatment group,the differences statically significant（P〈0.05）,and which of patients 1w after operation in combination group has approached the state before operation.The differences of eye opening time after operation compared with the two groups was no statistical significance（P〉0.05）,the extubation time and the linguistic response time of patients after operation in combination group were sooner than which in routine treatment group, the differences statically significant（P〈0.05）. Conclusion Compared with the anesthesia method of simple remifentanil, sevoflurane combined remifentanil could effectively reduce the incidence of cognitive function after operation of patients, could recovered the vital signs of patients in a short time after operation, has shorter extubation time and shorter awake time.