老年患者应用异氟醚和七氟醚影响术后认知功能的探讨

The Effect of Isoflurane and Sevoflurane on Postoperative Cognitive Function in Elderly Patients

目的针对老年患者采用异氟醚和七氟醚麻醉术后1年影响其认知功能和血清β淀粉样蛋白浓度的情况进行分析研究。方法收集全麻方式实施腹部手术38例患者作为研究对象。按照患者采用的麻醉药物,将其分为异氟醚组和七氟醚组。在术前1天、术后3天及1年分别采用简易精神状态量表评价认知功能分数,并在上述时间检测血清中的Aβ_(40)和Aβ_(42)浓度。结果术后3天两组患者在MMSE评分均低于术前,且异氟醚组患者相对更低,差异均具有统计学意义(P<0.05);两组患者术后1年产生中枢神经系统并发症比例及不同时间下两组患者血清的Aβ_(40)和Aβ_(42)浓度对比,差异均不具有统计意义(P>0.05)。结论在影响老年患者近期认知功能方面,七氟醚低于异氟醚,但长期影响差异不大,不影响患者术后1年血清β淀粉样蛋白浓度。

Objective To study the effects of isoflurane and sevoflurane on the cognitive function and serumβamyloid protein concentration in the elderly patients after 1 years of anaesthesia.Methods A total of 38 patients undergoing abdominal surgery were enrolled in this study.They were divided into isoflurane group and sevoflurane group according to the anesthetic drugs used by patients.The cognitive function scores were evaluated by mini mental state scale 1 day before operation,3 days and 1 year after operation respectively.Serum concentrations of Aβ40 and Aβ42 were measured at the same time.Results On the 3 day after operation,the scores of MMSE in the two groups were all lower than those before the operation,and the patients in the isoflurane group were relatively lower,and the differences were statistically significant(P<0.05).The ratio of the complications of the central nervous system in the two patients after 1 year and the contrast of serum Aβ40 and Aβ42 in two groups of patients at different time were not statistically significant(P>0.05).Conclusion Sevoflurane is lower than isoflurane in the recent cognitive function of elderly patients,but the long-term effect has little difference and does not affect the serumβamyloid protein concentration of 1 year after operation.