七氟烷联合丙泊酚对老年直肠癌患者腹腔镜术后苏醒期躁动及认知功能效果分析

Effect of Sevoflurane Combined with Propofol on Postoperative Agitation and Cognitive Function in Elderly Patients with Rectal Cancer after Laparoscopic Surgery

目的研究七氟烷联合丙泊酚对老年直肠癌患者腹腔镜术后苏醒期躁动及认知功能效果。方法抽取2016年5月—2018年3月间该院收治的66例性腹腔镜的老年直肠癌患者作为研究资料,依据术中麻醉措施的差异将其以1:1的比例分为2组,在常规麻醉的基础上使用丙泊酚为对照组,观察组则实施七氟烷联合丙泊酚进行麻醉;对比苏醒期躁动情况、手术前后认知情况、术后不良反应(头晕、肢体痉挛、恶心呕吐)发生率、患者镇静满意度。结果观察组苏醒后120 min SAS为(3.85±0.56)分,Ramsay为(2.56±0.25)分,评分均低于对照组(t=4.015 5、6.595 0)。术后MMSE评分由术前(29.36±2.94)分降为术后(21.36±2.15)分(t=9.199 4)。观察组术后不良反应发生率9.0%,对照组30.3%(χ~2=4.693 8,P=0.03<0.05)。观察组镇静用药的满意度96.9%,对照组81.8%(χ~2=3.995 2,P=0.04<0.05)。结论在性腹腔镜手术的老年直肠癌患者的麻醉过程中给予七氟烷联合丙泊酚效果显著,值得临床推广。

Objective To study the effects of sevoflurane combined with propofol on postoperative agitation and cognitive function in el-derly patients with rectal cancer after laparoscopic surgery. Methods From May 2016 to March 2018 Sixty-six patients with laparoscopic laparoscopic rectal cancer were enrolled in the study. According to the difference of intraoperative anesthesia, they were divid-ed into two groups according to the difference of intraoperative anesthesia. Propofol was used on the basis of routine anesthesia for the control group, the observation group was treated with sevoflurane and propofol for anesthesia; compared with agitation during the re-covery period, cognitive status before and after surgery, postoperative adverse reactions(dizziness, limb paralysis, nausea and vomit-ing), patient satisfaction with sedation. Results The SAS of the observation group was(3.85 ±0.56)points and the Ramsay was(2.56±0.25)points. The scores were lower than the control group(t=4.015 5,6.595 0). The postoperative MMSE score decreased from preoperative(29.36±2.94)points to postoperative(21.36±2.15)points(t=9.199 4). The incidence of postoperative adverse reactions in the observation group was 9.0%, and that in the control group was 30.3%(χ~2=4.693 8, P=0.03<0.05). The satisfaction rate of sedative medication in the observation group was 96.9%, and the control group was 81.8%(χ~2=3.995 2, P=0.04<0.05). Conclusion The effect of sevoflurane combined with propofol in the anesthesia of elderly patients with rectal cancer during laparoscopic surgery is significant and worthy of clinical promotion.