七氟烷联合丙泊酚持续麻醉对老年下肢骨折手术效果及认知功能的影响

Effect of Sevoflurane Combined With Propofol on Surgical Effect and Cognitive Function of Lower Limb Fracture in Elderly Patients

目的分析七氟烷联合丙泊酚持续麻醉对老年下肢骨折手术效果及认知功能的影响。方法选择2019年3月~2020年3月聊城市退役军人医院收治的下肢骨折手术老年患者90例,按随机数表法分为两组,对照组45例使用丙泊酚联合右美托咪定进行麻醉,研究组45例在对照组基础上使用七氟烷,对两组手术效果及认知功能进行比较。结果研究组术后最大呼气流量(PEF)、第一秒用力呼气量/用力肺活量(FEV_(1)/FVC)、每分钟最大通气量(MVV)、第一秒用力呼气量的预计值(FEV_(1)%)均高于对照组,差异有统计学意义(P<0.05)。研究组术后6 h、24 h、72 h的认知功能评分均高于对照组,差异有统计学意义(P<0.05)。研究组术后去甲肾上腺素(NE)、肾上腺素(E)、皮质醇(Cor)各项应激指标水平均低于对照组,差异有统计学意义(P<0.05)。比较两组恶心呕吐、心动过缓、低血压等不良反应发生率,差异无统计学意义(P>0.05)。结论临床将七氟烷联合丙泊酚持续麻醉实施于下肢骨折手术老年患者中,麻醉效果显著,可减少术后不良反应的发生,安全性高。

Objective To analyze the effect of sevoflurane combined with propofol continuous anesthesia on lower limb fracture surgery and cognitive function in elderly patients.Methods 90 elderly patients with lower limb fracture surgery in our hospital from March 2019 to March 2020 were randomly divided into two groups.The control group(45 cases)was anesthetized with propofol combined with dexmedetomidine,and the study group(45 cases)was anesthetized with sevoflurane on the basis of the control group.Results maximum expiratory flow(PEF),FEV_(1)/FVC,maximum ventilation volume per minute(MVV)and first second forced expiratory volume(FEV_(1))in the study group were higher than those in the control group after operation,and the difference was statistically significant(P<0.05).The scores of cognitive function in the study group at 6 h,24 h and 72 h after operation were higher than those in the control group,and the difference was statistically significant(P<0.05).The stress indexes of norepinephrine(NE),epinephrine(E)and cortisol(Cor)in the study group were lower than those in the control group after operation,and the difference was statistically significant(P<0.05).Comparing the adverse reaction rates of nausea and vomiting,bradycardia and hypotension between the two groups,there was no significant difference(P>0.05).Conclusion Sevoflurane combined with propofol in the elderly patients with lower extremity fracture surgery,the anesthetic effect is remarkable,can reduce postoperative adverse reactions,high safety.