不同麻醉药物对腹腔镜胆囊切除术后早期认知功能的影响

Influence of different anesthetic drugs on early cognitive function after laparoscopic cholecystectomy

目的对比分析不同麻醉药物对腹腔镜胆囊切除术后早期认知功能的影响。方法将行腹腔镜胆囊切除术患者94例,按照随机表法分为A组与B组各47例。A组持续吸入2.0%七氟烷,B组持续泵注丙泊酚。比较2组术前、术后1、3 d MMSE评分,定向力恢复时间、拔管时间和睁眼时间变化,入室后、插管后、切除中及拔管时HR和血氧饱和度变化。结果 2组术后1 d MMSE评分较术前降低(P<0.05),B组术后3 d MMSE评分较术前降低(P<0.05);A组术后1、3 d MMSE评分高于B组(P<0.05)。A组定向力恢复时间、拔管时间及睁眼时间快于B组(P<0.05)。2组插管后和切除中HR较入室后降低(P<0.05),B组拔管时HR较入室后降低(P<0.05);A组插管后、切除中和拔管时HR低于同期B组(P<0.05)。结论七氟烷可降低腹腔镜胆囊切除术后早期认知功能障碍发生,且对血流动力学影响小。

Objective To compare and analyze the effects of different anesthetics on early cognitive function after laparoscopic cholecystectomy（LC）. Methods 94 patients undergoing laparoscopic cholecystectomy from July 2016 to July 2017 in our hospital were randomly divided into group A（47 cases） and group B（47 cases）. Group A received continuous inhalation of 2%, seven halothane, and group B continuous infusion of propofol. The preoperative and postoperative 1 d, 3 d MMSE score, directional recovery time, extubation time and opening time of the two groups were compared. The changes of HR and blood oxygen saturation after admission, after intubation, resection and extubation were compared. Results Two groups of postoperative 1 d MMSE score decreased（P〈0.05）, B group postoperative 3 d MMSE score decreased（P〈0.05）; Group A postoperative 1 d and 3 d MMSE were higher than those of group B（P〈0.05）. The recovery time, extubation time and opening time of group A were faster than those of group B（P〈0.05）. The two group after intubation and resection of HR（P〈0.05）, group B after extubation HR was lower（P〈0.05） into group A; after intubation, resection and extubation HR lower than group B（P〈0.05）. Conclusion Seven sevoflurane can reduce the early cognitive dysfunction after laparoscopic cholecystectomy, and has little effect on hemodynamics.