麻醉深度对老年患者术后认知功能障碍的影响临床分析

Clinical Analysis of the Effect of Anesthesia Depth on Postoperative Cognitive Dysfunction in Elderly Patients

目的分析麻醉深度对老年患者术后认知功能障碍的影响。方法选取郑州人民医院2018年1月-2019年1月收治的60例老年手术患者,随机分为观察组和对照组,每组30例,对照组患者接受浅度麻醉,观察组接受深度麻醉。对比两组患者术后8h、1d、3d的认知功能,以简易智力状态评估量表进行评估。另对比两组麻醉苏醒时间、心率、呼吸指标、不良反应发生率。结果观察组患者术后8h、1d、3d的认知功能得分为(1.4±0.3)分、(4.1±0.3)分、(4.2±0.4)分,对照组患者术后8h、1d、3d的认知功能得分分别为(1.1±0.2)分、(3.4±0.2)分、(3.5±0.3)分,两组对比,差异具有统计学意义(P<0.05,t=3.115、5.256、6.145)。观察组患者麻醉苏醒时间(4.1±0.7)h、心率(62.5±3.4)次/min、呼吸(16.6±1.5)次/min,对照组患者麻醉苏醒时间(3.6±0.5)h、心率(73.1±3.5)次/min、呼吸(18.3±1.4)次/min,两组对比,差异具有统计学意义(P<0.05,t=5.081、18.093、12.066)。两组患者不良反应发生率接近,差异无统计学意义(P>0.05)。结论深度麻醉模式下,老年患者术后的认知功能相对浅度麻醉更理想,但体征波动较大,且麻醉苏醒时间较长。

Objective To analyze the effect of anesthesia depth on postoperative cognitive dysfunction in elderly patients.Methods 60 elderly surgical patients admitted to Zhengzhou People’s Hospital from January 2018 to January 2019 were randomly divided into observation group and control group,with 30 cases in each group.The patients in the control group received shallow anesthesia and the observation group received deep anesthesia.The cognitive function of 8 h,1 d and 3 d after surgery were assessed with a simple intelligence status assessment scale and were compared between the two groups of patients.Anaesthetic wake-up time,heart rate,respiratory index and incidence of adverse reactions were compared between the two groups.Results The cognitive function scores of the patients in the study group at 8 h,1 d and 3 d after surgery were(1.4±0.3),(4.1±0.3),and(4.2±0.4),and the cognitive function scores of the control group at 8 h,1 d and 3 d after surgery were(1.1±0.2),(3.4±0.2),(3.5±0.3),the difference between the two groups is statistically significant(P<0.05,t=3.115,5.256,6.145).The anaesthetic wake-up time(4.1±0.7)h,heart rate(62.5±3.4)times/min,breathing(16.6±1.5)times/min,control group patients anaesthetic wake-up time(3.6±0.5)h,heart rate(73.1±3.5)time/min,breath(18.3±1.4)time/min of the observation group were significantly different from those of the group(P<0.05,t=5.081,18.093,12.066).The incidence of adverse reactions was similiar in the two groups,and the difference was not significant(P>0.05).Conclusion In the deep anesthesia mode,the cognitive function of the elderly patients after surgery is more ideal,but accompanies more fluctuate signs longer anaesthetic wake-up time.