不同麻醉深度对老年腹腔镜手术患者脑功能及术后认知功能的影响

Effect of different anesthesia depth on brain function and postoperative cognitive function of elderly patients undergoing laparoscopic surgery

目的老年腹腔镜手术患者采用不同麻醉深度对其脑功能及术后认知功能的影响。方法选取我院收治的老年腹腔镜手术患者124例,按照麻醉深度不同进行分组,浅度麻醉组62例,深度麻醉组62例,对比两组患者麻醉诱导前(T1)、麻醉诱导后(T2)、插管结束后(T3)及手术1 h(T4)的血流动力学指标、脑功能、认知功能。结果两组患者T1、T2、T3及T4时间点平均动脉压水平比较,P>0.05。两组患者T1时间点血清S-100β蛋白水平比较,P>0.05;两组患者T2、T3、T4时间点血清S100β蛋白水平比较,P<0.05。两组患者术前及术后第7天简易智力状态检查(MMSE)评分比较,P>0.05;两组患者术后第1天、第3天MMSE评分比较,P<0.05。结论深度麻醉可抑制炎性因子释放,减轻应激反应,保护患者脑功能,降低认知功能障碍的发生。

Objective To explore the effect of different anesthesia depth on brain function and postoperative cogni⁃tive function of elderly patients undergoing laparoscopic surgery.Methods A total of 124 elderly patients undergoing laparoscopic surgery in our department were selected as research objects and grouped according to different anesthetic depths,62 patients in the shallow anesthesia group and 62 patients in the deep anesthesia group.The hemodynamic index,brain function and cognitive function of the two groups at the time points of before intubation(T1),after anesthesia in⁃duction(T2),after intubation(T3)and 1 h after surgery(T4)were compared.Results The average arterial pressure of the two groups at the time points of T1,T2,T3 and T4 were compared with P>0.05.Comparison of serum S-100βpro⁃tein level at T1 between the two groups was with P>0.05.The serum S-100βprotein level of the two groups at T2,T3 and T4 were compared with P<0.05.The comparison of preoperative simple mental state examination(MMSE)score between the two groups before surgery and 7 d after surgery were with P>0.05,the simple mental state examination(MMSE)scores of the two groups at 1 d after surgery and 3 d after surgery were compared with P<0.05.Conclusion Deep anes⁃thesia can inhibit the release of inflammatory factors,reduce stress response,protect brain function and reduce cognitive dysfunction.