丙泊酚与七氟烷分别复合芬太尼对普外科胸部手术后认知功能的影响

Effects of propofoi and sevoflurane combined with fentanyl on cognitive function after general thoracic surgery

目的探讨丙泊酚与七氟烷分别复合芬太尼对胸部手术后认知功能的影响效果。方法收集2015年7月至2016年7月人院的200例行全身麻醉的胸部手术患者，随机分为A组与B组，各100例。A组采用丙泊酚复合芬太尼麻醉，B组采用七氟烷复合芬太尼麻醉；比较两组手术期间生命体征水平、变化趋势、手术前后认知水平与不良反应。结果于T。与B时点，A组患MAP[（102．68±8．42）、（103．33±9．22）]与HR水平[（77．21±7．15）、（77．05±7．07）]显著低于B组[（113．66±8．72）、（115．84±8．67）与（88．20±7．32）、（86．33±7．11）]，Sp02水平[（95．05±2．01）、（94．30±1．87）]显著高于B组[（90．36±1．98）、（88．10±1．89）1，差异有统计学意义（P〈0．01）；A组麻醉期间MAP、HR与Sp02变化相对较为平稳，而B组MAP、HR与Sp02在T1与L时点波动较大；A组术后24hMMSE评分（26．72±0．99），B组（25．10±0．89），差异有统计学意义（P〈0．01）；两组术后不良反应发生率差异无统计学意义（2％VS．4％，P〉0．05）。结论丙泊酚复合芬太尼对胸部手术患者的生命体征与认知功能影响相对更小，且安全性较高，具有借鉴意义。

Objective To investigate the effects ofpropofol and sevoflurane combined with fentanyl on cognitive function after thoracic surgery. Methods 200 patients taking thoracic surgery at our hospitalfrom July, 2015 to July, 2016 were collected and randomly divided into group A and group B, 100 for each group. Group A took propofol and fentanyl for anesthesia and group B sevoflurane and fentanyl. The levels of vital signs, trends, cognitive levels before and after surgery, and adverse reactions were compared between these two groups. Results At T1 and T3, the MAP, HR, and SpO2 were （ 102.68±8.42 ） and （ 103.33±9.22 ）, （ 77.21±7.15 ） and （ 77.05±7.07 ）, and （95.05±2.01）, （94.30±1.87） in groupAandwere （113.66±8.72） and （115.84±8.67）, （88.20±7.32） and （ 86.33±7.11 ）, and （ 90.36±1.98 ） and （88.10±1.89） in group B, respectively, with statistical differences （ P 〈 0.01 ） . During anesthesia period, the MAP, HR, and SpO2 were relatively stable in group A and changed a lot at T1 and T3 in group B. 24 h after surgery, the MMSE was （26.72 ± 0.99） in group A and （25.10±0.89） in group B, with a statistical difference. There was no statistical difference in the incidence of postoperative adverse reactions between these two groups （2% vs. 4%, P 〉 0.05）. Conclusion The signs and cognitive function of propofol combined with fentanyl for patients taking thoracic surgery has less effect on the patients＇ vital signs and cognitive function and highly safe, so it is of reference.