七氟醚-瑞芬太尼静吸复合麻醉对妇科腹腔镜子宫肌瘤摘除术患者术后认知功能的影响

Effect of Sevoflurane and Remifentanil Combined with Anesthesia on Postoperative Cognitive Function in Patients Undergoing Gynecological Laparoscopic Myomectomy

目的:分析七氟醚-瑞芬太尼静吸复合麻醉对妇科腹腔镜子宫肌瘤摘除术患者术后认知功能的影响。方法:选取我院妇科收治行腹腔镜子宫肌瘤摘除术患者148例,采取数字随机法分成观察组和对照组,观察组采取七氟醚-瑞芬太尼静吸复合麻醉,对照组采取丙泊酚-瑞芬太尼静脉复合麻醉,比较两组麻醉方式对术后认知功能的影响。结果:对照组患者术后1天认知功能评分低于术前1天,差异有统计学意义(P<0.05)。观察组患者术后1天认知功能评分高于对照组,差异有统计学意义(P<0.05)。对照组患者术后1天TMT完成时间慢于术前1天,差异有统计学意义(P<0.05)。观察组患者术后1天TMT完成时间快于对照组,差异有统计学意义(P<0.05)。观察组患者术后呼吸抑制、恶心呕吐、躁动、嗜睡、头晕发生率均低于对照组,差异有统计学意义(P<0.05)。结论:七氟醚-瑞芬太尼静吸复合麻醉对妇科腹腔镜子宫肌瘤摘除术患者术后认知功能的影响较小,并且比较安全,是较为适宜的麻醉方法。

Objective： To analyze the effect of sevoflurane and remifentanil combined anesthesia on postoperative cognitive function in patients undergoing gynecological laparoscopic myomectomy. Methods： 148 patients undergoing laparoscopic removal of uterine fibroids were selected and randomly divided into observation group and control group. The observation group adopted sevoflurane remifentanil anesthesia, and the control group took propofol remifentanil intravenous anesthesia. The effect on postoperative cognitive function of the two kinds of anesthesia was compared. Results： Among patients in control group, the cognitive function score 1 day after the operation was lower than that 1 day before operation, and the difference was statistically significant （P〈0.05）. Among patients in ob- servation group, the cognitive function score 1 day after the operation was higher than that 1 day before operation, and the difference was statistically significant （P〈0.05）. In control group, the TMT completion time 1 day after operation is more than that 1 day before operation, and the difference was statistically significant （P〈0.05）. In observation group, the TMT completion time 1 day after operation is less than that 1 day before operation, and the difference was statistically significant （P〈0.05）. The occurrence rate of postoperative respiratory inhibition, nausea and vomiting, restlessness, dizziness, lethargy in observation group was lower than that in control group, the difference was statistically significant （P〈0.05）. Conehtsion： Sevoflurane and remifentanil combined anesthesia has less influence on postoperative cognitive function in patients under laparoscopic myomectomy, and is relatively safe, which is a more suitable anesthesia method.