七氟烷麻醉对老年肺癌患者术后认知功能的影响

Effect of Sevoflurane Anesthesia on Postoperative Cognitive Function in Elderly Patients with Lung Cancer

目的探讨七氟烷麻醉对老年肺癌患者术后认知功能的影响。方法选择医院2015年12月至2017年10月收治的局限性晚期非小细胞肺癌手术治疗患者90例,按照随机数字表法分为观察组与对照组,各45例。所有患者均在全身麻醉双腔气管插管下实施开胸肺癌根治术,对照组患者术中维持使用丙泊酚,观察组患者术中维持采用七氟烷静吸复合给药。结果术后6 h,观察组患者心率慢于对照组患者(P<0.05),平均动脉压低于对照组患者(P<0.05);术后,观察组患者神经元特异性烯醇化酶(NSE)及血浆S-100B蛋白水平均显著低于对照组患者(P<0.05),观察组患者抗氧化能力相关指标中丙二醛、超氧化物歧化酶与总抗氧化能力均明显优于对照组患者(P<0.05);观察组患者术后6,12,24 h简易精神状态量表(MMSE)评分均显著优于对照组患者(P<0.05)。结论对实施全身麻醉的老年肺癌患者使用七氟烷术中维持麻醉,能显著降低抑制性蛋白水平,提高机体抗氧化能力,改善术后认知功能,值得临床推广。

Objective To investigate the effect of sevoflurane anesthesia on postoperative cognitive function in elderly patients with lung cancer. Methods Totally 90 patients undergoing locally advanced non-small cell lung cancer surgery admitted to our hospital from December 2015 to October 2017 were selected and divided into the observation group and the control group according to the random number table method, 45 cases in each group. All the patients were underwent thoracotomy for radical resection of lung cancer under general anesthesia and double cavity tracheal intubation. The patients in the control group was maintained with propofol during the operation,while the patients in the observation group was maintained with sevoflurane inhalation. Results 6 h after operation, the heart rate in the observation group was slower than that in the control group（ P 〈 0. 05）, and the mean arterial pressure in the observation group was lower than that in the control group（ P 〈 0. 05）. After operation,the levels of NSE and S-100B protein in the observation group were significantly lower than those in the control group（ P 〈 0. 05）. After operation, the related indexes of antioxidant capacity（ MDA and SOD） and total antioxidant capacity of the observation group were significantly better than those of the control group（ P 〈 0. 05）.6,12,24 h after operation,the scores of MMSE in the observation group were significantly better than those of the control group（ P 〈 0. 05）.Conclusion The use of sevoflurane to maintain anesthesia in elderly patients with lung cancer undergoing general anesthesia can significantly reduce the level of inhibitory protein,improve antioxidant capacity and the postoperative cognitive function,which is worthy of clinical promotion.