七氟烷和丙泊酚对老年患者腹腔镜胆囊切除术后认知功能的影响研究

Influence of sevoflurane and propofol on postoperative cognitive function in elder patients with laparoscopic cholecystectomy

目的探讨七氟烷和丙泊酚对老年患者腹腔镜胆囊切除术后认知功能的影响。方法选择2016年3月至2016年9月择期行腹腔镜胆囊切除的患者共60例,分为七氟醚组(S组)和丙泊酚组(P组),每组30例。比较两组患者术后简易认知功能筛查表(MMSE)评分和术后认知功能障碍(POCD)发生率。结果 T_0时,P组和S组患者的MMSE评分比较差异无统计学意义(P>0.05);T_1和T_2时,S组患者的MMSE值明显低于P组,且T_1时S组患者的POCD发生率明显高于P组;T_3时,两组患者MMSE评分、POCD发生率比较差异无统计学意义(P>0.05)。S组患者在T_1、T_2、T_3时的MMSE评分均较T_0明显降低(P<0.05);P组患者在T_1、T_2时的MMSE评分均较T_0明显降低(P<0.05),在T3时逐渐恢复。结论与丙泊酚相比,七氟烷对老年患者POCD发生的影响更加显著且持久。

Objective To investigate the influence of sevoflurane and propofol on postoperative cognitive dysfunction in elderly patients with laparoscopic cholecystectomy. Methods Sixty elderly patients scheduled for elective laparoscopic cholecystectomy in our hospital from March 2016 to September 2016 were selected and divided into the sevoflurane group（S） and propofol group （P）, 30 eases in each group. Postoperative mini-mental state examination（MMSE） score and occurrence rate of postoperative cogni- tive dysfunction（POCD） were compared between two groups. Results The MMSE score at To had no statistical difference between the two groups;the MMSE score at T1 and T2 in the group S was significantly lower than that in the group P,moreoyer the occurrence rate of POCD at T1 in the group S was significantly higher than that in the group P;The MMSE score and POCD occurrence rate at T3 had no statistical difference between the two groups（P〉0.05）. The MMSE score at T1, T2 and T3 in the group S was significantly decreased compared with that at T0 （P〈0.05）;the MMSE score at T1 and T2 in the group P was significantly decreased compared with that at To （P〈 0. 05）, and which at T3 was gradually recovered. Conclusion Compared with propofol, sevoflurane has more significant and persistent influence on POCD occurrence.