丙泊酚和七氟醚对胆囊炎胆石症患者血流动力学和认知功能的影响

Effects of Propofol and Sevoflurane on Hemodynamics and Cognitive Function in Patients with Cholecystitis and Cholelithiasis

目的探究丙泊酚和七氟醚对胆囊炎胆石症患者血流动力学的影响以及MMSE认知功能评分、麻醉效果、不良反应发生率的比较。方法选取110例胆囊炎胆石症手术患者,60例作为丙泊酚组,50例作为七氟醚组,丙泊酚组施用丙泊酚麻醉,七氟醚施用七氟醚麻醉。比较两组人员T_(0)(麻醉诱导前)、T_(1)(插管2 min后)、T_(2)(气腹5 min后)、T_(3)(手术结束60 min后)4个时间点的血流动力学指标、以及T_(0)(麻醉诱导前)、T_(4)(手术结束6 h后)、T_(5)(手术结束72 h后)的MMSE认知功能评分、手术过程中的麻醉效果以及不良反应发生率。结果两组人员心率、血氧饱和度、收缩压、在T_(0)均无显著差异,心率、血氧饱和度、平均动脉压先降后升回复最初水平,两组人员MMES评分在T_(4)较T_(0)明显降低,丙泊酚组MMES评分在T_(4)明显高于七氟醚组。丙泊酚组自主呼吸时间、言语应答时间、睁眼时间、拔管时间均比七氟醚组明显快。丙泊酚组的不良反应发生率低于七氟醚组。结论丙泊酚与七氟醚相比对胆囊炎胆石症患者手术麻醉影响更小,更适用于胆囊炎胆石症患者手术麻醉。

Objective To investigate the effect of propofol and sevoflurane on hemodynamics in patients with cholecystitis and cholelithiasis,as well as the comparison of MMSE cognitive function score,anesthesia effect and incidence of adverse reactions.Methods 110 patients with cholecystitis and cholelithiasis admitted were selected,60 cases were in the propofol group,and 50 cases were in the sevoflurane group.Sevoflurane anesthesia is administered with sevoflurane.The hemodynamic indexes of the two groups at four time points T0(before anesthesia induction),T1(2 minutes after intubation),T2(5 minutes after pneumoperitoneum),and T3(60 minutes after the end of surgery)were compared.And the MMSE cognitive function scores of T0(anesthesia induction),T4(6 h after the operation),T5(72 h after the operation)were compared.The anesthesia effect during the operation and the incidence of adverse reactions were also compared.Results There were no significant differences in heart rate,blood oxygen saturation,systolic blood pressure,and T0 between the two groups.Heart rate,blood oxygen saturation,and mean arterial pressure first decreased and then increased back to the initial level.The MMES scores of the two groups at T4was significantly lower than T0,and the MMES score in the propofol group was significantly higher than that in the sevoflurane group.The spontaneous breathing time,verbal response time,eye opening time,and extubation time in the propofol group were significantly faster than those in the sevoflurane group.The incidence of adverse reactions in the propofol group was lower than that in the sevoflurane group.Conclusion Compared with sevoflurane,propofol has less effect on surgical anesthesia in patients with cholecystitis and cholelithiasis,and is more suitable for surgical anesthesia in patients with cholecystitis and cholelithiasis.