不同麻醉方法对老年消化道肿瘤手术患者的麻醉效果及对患者术后早期认知功能的影响

Anesthetic effect of different anesthesia methods on elderly patients with digestive tract tumors and their effects on early cognitive function after operation

目的探讨不同麻醉方法对老年消化道肿瘤患者的麻醉效果及对患者术后早期认知功能的影响。方法选取2017年3月至2018年4月山西大医院收治的老年消化道肿瘤患者90例,根据随机数字表法分为对照组(n=45)和观察组(n=45)。两组均给予手术治疗,对照组采用异丙酚全凭静脉麻醉,观察组在对照组基础上联合七氟醚静吸复合麻醉。采用简易精神状态检查量表(MMSE)对两组麻醉前、后认知功能进行评估,比较两组麻醉效果及对患者术后早期认知功能的影响。结果观察组呼吸恢复时间、苏醒时间及拔管时间均短于对照组(P<0.05);两组术前、术后24hMMSE评分比较差异未见统计学意义(P>0.05);观察组术后1、12hMMSE评分均高于对照组(P均<0.05)。结论异丙酚全凭静脉麻醉联合七氟醚静吸复合麻醉对老年消化道肿瘤患者早期认知功能影响较小,值得推广应用。

Objective To investigate the anesthetic effects of different anesthesia methods on elderly patients with digestive tract tumors and their influence on early cognitive function after operation.Methods A total of 90 elderly patients with gastrointestinal cancer admitted to the Shanxi Dayi Hospital from March 2017 to April 2018 were randomly divided into control group(n=45)and observation group(n=45).Surgical treatment was given to both groups.Patients in control group were treated with propofol intravenous anesthesia.Patients in observation group were treated with sevoflurane inhalation anesthesiaon on the basis of the control group.The Mini-Mental State Examination(MMSE)scale was used to evaluate the cognitive function before and after anesthesia in both groups.The effects of anesthesia and early cognitive function after operation were compared between the two groups.Results The recovery time,recovery time and extubation time of observation group were shorter than those of control group(P<0.05).There was no significant difference in the MMSE score between the two groups before operation and 24 hours after operation(P>0.05).The MMSE scores at 1 h and 12 h after surgery were higher than those in control group(P<0.05).Conclusions Propofol intravenous anesthesia combined with sevoflurane inhalation anesthesia on has little effect on early cognitive function in elderly patients with gastrointestinal cancer.It is worthy of popularization and application.