七氟醚复合麻醉对纯二尖瓣病变患者术后认知功能及神经功能的影响

Effects of sevoflurane combined anesthesia on postoperative cognitive function and neurological function in patients with pure mitral valve disease

目的探讨七氟醚复合麻醉对纯二尖瓣病变患者术后认知功能及神经功能的影响。方法选择2016年3月至2017年10月胶州市人民医院择期行心脏二尖瓣置换术的纯二尖瓣病变患者112例,以随机数表法分为对照组(56例)和试验组(56例)。对照组接受丙泊酚复合麻醉,试验组接受七氟醚复合麻醉。对比两组麻醉诱导前、体外循环开始后0. 5 h、术毕、术后12 h的血清神经损伤指标[神经元特异性烯醇化酶(NSE)、S-100β蛋白]水平,术前、术后2 d的认知功能评分(MMSE),术后2 d时认知功能障碍(POCD)发生率。结果试验组体外循环开始后0. 5 h、术毕、术后12 h的血清NSE、S-100β蛋白水平均较对照组低(P <0. 05)。试验组术后2 d的MMSE评分高于对照组,POCD发生率低于对照组(P <0. 05)。结论七氟醚复合麻醉对纯二尖瓣病变患者术后认知功能及神经功能影响小,利于减少术后认知功能障碍的发生。

Objective To explore the effects of sevoflurane combined anesthesia on postoperative cognitive function and neurological function in patients with pure mitral valve disease.MethodsA total of 112 patients with pure mitral valve disease who underwent mitral valve replacement in Jiaozhou People’s Hospital from March 2016 to October of 2017 were selected and randomly divided into control group(56 cases)and experimental group(56 cases).The control group received propofol combined anesthesia and the experimental group received sevoflurane combined anesthesia.The levels of serum neuron-specific enolase(NSE)and S-100 beta protein(S-100 beta)before anesthesia induction,0.5 hours after cardiopulmonary bypass,12 hours after operation,the cognitive function score(MMSE)before and 2 days after operation,and the incidence of cognitive dysfunction(POCD)at 2 days after operation were compared between the two groups.ResultsThe levels of serum NSE and S-100 beta protein in the experimental group were lower than those in the control group at 0.5 h,12 h after CPB(P<0.05).The MMSE score of the experimental group at 2 d after operation was higher than that of the control group,and the incidence of POCD was lower than that of the control group(P<0.05).ConclusionSevoflurane combined anesthesia has little effect on postoperative cognitive function and neurological function in patients with pure mitral valve disease,which is conducive to reducing the incidence of postoperative cognitive dysfunction.