全凭静脉麻醉与吸入麻醉对老年患者腹部术后认知功能和血清S100蛋白水平的影响

Effects of Intravenous Anesthesia and Inhalation anesthesia on Cognitive Function and Serum S100 beta Protein Levels in the Elderly Patients After Abdominal Surgery

目的对比观察全凭静脉麻醉与吸入麻醉对老年患者腹部术后认知功能和血清S100蛋白水平的影响,以明确降低老年患者术后认知功能障碍更有效的麻醉方式。方法选择在我院进行肠和胃腹部手术的老年患者140例,根据不同的麻醉方式随机分为观察组(=70)和对照组(=70)。观察组手术时采取全凭静脉麻醉,对照组手术时采取吸入麻醉。采用简易精神状态检查表(MMES)评估患者的认知功能,采用酶联免疫吸附法检测患者的血清S100蛋白水平。对2组测得的结果进行分析与比较。结果术前和术后1 d,2组的MMES评分均无显著差异(>0.05);术后1 h、3 h、6 h,观察组的MMES评分均显著高于对照组(<0.05)。术前2组的血清S100蛋白含量无显著差异;术后1 h、1 d、2 d、3d观察组的S100蛋白含量均显著低于对照组(<0.05)。结论对于老年手术患者,全凭静脉吸入麻醉能使术后认知功能恢复较快,可能与血清S100蛋白含量下降有关;全凭静脉吸入麻醉在老年腹部手术临床上具有一定的应用价值。

Objective To compare the effects of intravenous anesthesia and inhalation anesthesia on cognitive function and serum S100 beta protein levels in elderly patients after abdominal surgery, so as to clarify the more effective anesthesia method to reduce postoperative cognitive dysfunction in elderly patients. Methods 140 elderly patients undergoing intestinal and gastric abdominal surgery were randomly divided into observation group （n=70） and control group （n=70） according to different anesthesia methods. The observation group was given intravenous anesthesia during operation, the control group was given inhalation anesthesia during operation. The cognitive function of the patients was assessed by Mini-Mental State Examination scores （MMES）, and the serum S100 beta protein level was detected by enzyme-linked immunosorbent assay. The results of the 2 groups were analyzed and compared. Results There existed no obvious statistical difference in MMES before surgery and 1 day after surgery between the 2 groups （P〉 0.05）, while the MMES at the time point of 1 hour, 3 hours and 6 hours in observation group were much higher than those in control group with a statistical difference （P〈 0.05）. There was no significant difference in serum S100 beta protein between the two groups before operation, and the S100 beta protein content of observation group was significantly lower than those of control group at at the time point of 1 hour, 1 day, 2 days and 3 days after operation （P 〈 0.05）. Conclusions For elderly patients undergoing surgery, intravenous anesthesia can make postoperative cognitive function recovery faster, which may be related to the decrease of serum S100 beta protein content; Intravenous anesthesia has a certain clinical value in elderly abdominal surgery.