术中丙泊酚麻醉维持对全子宫切除术患者麻醉苏醒期及术后认知功能的影响

Effect of Propofol Anesthesia during Anesthesia on Recovery Period and Postoperative Cognitive Function in Patients Undergoing Total Hysterectomy

目的:探讨给予全子宫切除术患者术中丙泊酚麻醉维持对患者麻醉效果、术后认知功能的影响。方法:选取2017年1月至2018年1月在我院接受全子宫切除术治疗患者87例,根据麻醉方法不同将患者分为观察组(n=45)和对照组(n=42)。对照组患者术中给予七氟烷治疗,观察组术中给予丙泊酚麻醉干预。观察两组患者治疗前、治疗后血糖、皮质醇、心率、动脉压、认识功能变化,记录患者自主呼吸恢复时间、睁眼时间、拔管时间、定力恢复时间,比较治疗后患者不良反应发生率。结果:治疗后,两组患者皮质醇、血糖等应激反应表达水平均高于治疗前,但观察组以上指标明显低于对照组(P<0.05);治疗后,两组患者心率、动脉压均低于治疗前,且观察组以上指标明显高于对照组(P<0.05);治疗后,两组患者认知功能均有降低,但观察组高于对照组(P<0.05)。治疗后,观察组患者自主呼吸恢复时间、睁眼时间、拔管时间、定力恢复时间均分别短于对照组患者(P<0.05);治疗期间,两组患者均有出现拔管呛咳、躁动、恶性呕吐、苏醒延迟、寒颤等不良反应,观察组总发生率11.11%明显低于对照组33.33%(P<0.05)。结论:给予全子宫切除术患者术中丙泊酚麻醉干预,可降低机体应激反应,对患者认知功能影响小,麻醉效果好,不良反应小,效果显著,值得临床推广使用。

Objective:To investigate the effect of propofol anesthesia maintenance on patients'anesthesia effect and postoperative cognitive function during total hysterectomy.Methods:87 patients were treated with total hysterectomy from January 2017 to January 2018 in our hospital.According to the different methods of anesthesia,the patients were divided into the observation group(n=45)and the control group(n=42).The control group was given seven halothane during the operation,while the observation group was given propofol anesthesia during the operation.The changes of blood glucose,cortisol,heart rate,arterial pressure and cognitive function were observed before and after treatment in the two groups.The time of spontaneous breathing recovery,opening time,extubation time,setting time of force recovery were recorded,and the incidence of adverse reaction after treatment was compared.Results:After treatment,the levels of cortisol,blood sugar and other stress responses in the two groups were higher than those before treatment,but the above indexes in the observation group were significantly lower than those in the control group(P<0.05).After treatment,the heart rate and arterial pressure in the two groups were lower than those before the treatment,and the above indexes were significantly higher than those in the control group(P<0.05).After treatment,the cognitive work of the two groups of patients was found.They all decreased,but the observation group was higher than that of the control group(P<0.05).After treatment,the time of spontaneous breathing recovery,opening time,extubation time and restoring time were shorter in the observation group than in the control group(P<0.05).During the treatment,the two groups had adverse reactions such as extubation and choking,restlessness,malignant vomiting,waking delay and shivering.The total incidence of the observation group was 11.11%.33.33%(P<0.05)was lower than that of the control group.Conclusion:The intervention of propofol anesthesia in patients with total hysterectomy can reduce the stress response and inflammatory reaction of the body.It has little effect on the cognitive function of the patients,the effect of anesthesia is good,the adverse reaction is small,and the effect is remarkable.It is worthy of clinical application.