瑞芬太尼联合丙泊酚对躁狂症患者电休克治疗后的再定向时间和认知功能的影响

The Effect of Remifentanil Combined with Propofol on the Reorientation Time and Cognitive Function of Patients with Mania after Electroconvulsive Therapy

目的:探究瑞芬太尼联合丙泊酚对躁狂症患者电休克治疗后的再定向时间和认知功能的影响。方法:招募2018年2月至2019年9月在本院就诊的150例躁狂症患者,将患者分为对照组和观察组,各75例。通过简易精神状态检查(MMSE)评分系统比较电休克疗法(ECT)后的认知障碍。通过杨氏躁狂量表(YMRS)评分系统比较躁狂症患者的狂躁严重程度。通过MMSE评分系统比较躁狂症患者ECT后的时间定向能力。通过无创血压和心电图监测患者ECT前后的平均动脉压和心率。结果:两组患者一般资料统计无差异(P>0.05)。观察组术后5小时无障碍率较对照组升高(P<0.05),观察组术后5小时出现严重认知障碍率较对照组降低(P<0.05),中度认知障碍率两组比较无差异(P>0.05)。ECT后5小时和24小时观察组与对照组的YMRS评分比较无差异(P>0.05)。ECT前,观察组时间定向评分与对照组比较无差异(P>0.05),ECT后,观察组时间定向评分较对照组升高(P<0.05)。ECT前和ECT后,观察组的平均动脉压和心率比较无差异(P>0.05)。结论:在接受ECT的躁狂患者中,瑞芬太尼补充丙泊酚诱导麻醉不影响ECT的疗效,并且能减少ECT后认知障碍的发生,缩短重定向时间。

Objective:To explore the effect of remifentanil combined with propofol on the reorientation time and cognitive function of patients with mania after electroconvulsive therapy.Methods:A total of 150 patients with mania treated in the our hospital from February 2018 to September 2019 were recruited and divided into control group and observation group,with 75 cases in each group.Cognitive impairment after electroconvulsive therapy(ECT)was compared by the MMSE scoring system.Young’s Manic Scale(YMRS)score was used to compare the severity of mania in patients with mania.MMSE scoring system was used to compare the time orientation ability of patients with mania after ECT.Mean arterial pressure and heart rate before and after ECT were monitored by noninvasive blood pressure and electrocardiogram.Results:There was no difference in general data between the two groups(P>0.05).The barrier-free rate of observation group at 5 hours after operation was higher than that of control group(P<0.05),the rate of severe cognitive impairment at 5 hours after operation in observation group was lower than that of control group(P<0.05),the rate of moderate cognitive impairment in the two groups There was no difference(P>0.05).There was no difference in YMRS scores between the observation group and the control group at 5 hours and 24 hours after ECT(P>0.05).Before ECT,the time-oriented score of the observation group was not different from that of the control group(P>0.05).After ECT,the time-oriented score of the observation group was higher than that of the control group(P<0.05).Before ECT and after ECT,there was no difference in mean arterial pressure and heart rate of the observation group(P>0.05).Conclusion:In manic patients receiving ECT,remifentanil supplementation with propofol-induced anesthesia does not affect the efficacy of ECT,and can reduce the occurrence of cognitive impairment after ECT and shorten the redirection time.