心瓣膜置换术应用靶控输注依托咪酯对患者术后认知功能的影响

Effect of target controlled infusion of etomidate on postoperative cognitive function in patients undergoing heart valve replacement

目的探讨心瓣膜置换术应用靶控输注依托咪酯对患者术后认知功能的影响。方法选取2018年1月至2019年5月本院收治的心脏瓣膜置换术患者40例,采用随机数字表法分为研究组(n=20,术中行靶控输注依托咪酯)和对照组(n=20,术中行靶控输注丙泊酚),比较两组患者不同时间点血流动力学及认知功能变化情况。结果两组T0时MAP、HR比较差异无统计学意义,术中各时间点,研究组MAP、HR水平均高于对照组,差异有统计学意义(P<0.05);两组术前MMSE量表评分比较差异无统计学意义,术后1、5、7 d,两组MMSE量表评分均低于术前(P<0.05),出院当天两组MMSE量表评分均恢复至术前水平,两组比较差异无统计学意义。结论对心脏瓣膜置换术患者应用靶控输注依托咪酯有利于维持术中机体血流动力学稳定,对患者围术期认知功能具有较好的保护作用。

Objective To investigate the effect of target controlled infusion of etomidate on postoperative cognitive function in patients undergoing heart valve replacement. Methods From January 2018 to May 2019, 40 patients with cardiac valve replacement in our hospital were randomly divided into study group(n=20, target controlled infusion of etomidate) and control group(n=20, target controlled infusion of propofol).Results There was no significant difference in map and HR between the two groups at T0. The level of MAP and HR in the study group was higherthan that in the control group at all time points during operation(P<0.05). There was no significant difference in MMSE scores between the two groups before operation. The scores of MMSE scale in the two groups were lower than those before operation at 1, 5 and 7 days after operation(P<0.05). On the day of discharge, the scores of MMSE scale in both groups returned to the preoperative level, and there was no significant difference between the two groups. Conclusion Target controlled infusion of etomidate in patients with heart valve replacement is beneficial to maintain the stability of hemodynamics during the operation and has a better protective effect on the cognitive function of patients during the perioperative period.