静吸复合麻醉与单纯静脉麻醉对老年子宫肌瘤腹腔镜切除术患者认知功能的影响

Effects of Intravenous-inhalation Combined Anesthesia and Intravenous Anesthesia Alone on Cognitive Function in Elderly Patients Undergoing Laparoscopic Resection for Uterine Fibroids

目的探求采用单纯静脉麻醉或静吸复合麻醉进行腹腔镜切除术对老年子宫肌瘤患者术后认知功能的影响。方法方便选取2020年5月—2022年5月高密市市立医院妇科收治的92例老年子宫肌瘤患者为研究对象,采用随机数表法将其分为观察组和参照组,每组46例。两组患者均行子宫肌瘤腹腔镜切除术,参照组手术麻醉方法采用单纯静脉麻醉,观察组手术麻醉方法采用静吸复合麻醉。比较两组麻醉效果、术后不良反应发生率、应激指标水平,认知功能。结果观察组麻醉起效时间、术后苏醒时间以及拔管时间均短于参照组,差异有统计学意义(P<0.05)。术前,两组MMSE评分比较,差异无统计学意义(P>0.05);拔管6 h、拔管12 h和术后第3天观察组MMSE评分均高于参照组,差异有统计学意义(P<0.05)。术前,两组SOD和MDA水平比较,差异无统计学意义(P>0.05);术后24 h,观察组SOD水平高于参照组,MDA水平低于参照组,差异有统计学意义(P<0.05)。观察组不良反应发生率为8.70%(4/46)低于参照组的13.04%(6/46),差异无统计学意义(χ^(2)=0.449,P=0.503)。结论静吸复合麻醉较单纯静脉麻醉在老年子宫肌瘤腹腔镜切除术的应用中对患者认知功能的影响较小,可提高麻醉效果,减轻患者应激及不良反应。

Objective To investigate the effect of intravenous anesthesia alone or intravenous anesthesia combined with intravenous anesthesia on postoperative cognitive function in elderly patients with uterine fibroids.Methods A total of 92 elderly patients with uterine fibroids admitted to the Department of Gynecology of Gaomi Municipal Hospital from May 2020 to May 2022 were conveniently selected as the research objects.They were divided into observation group and reference group by random number table method,with 46 cases in each group.Both groups underwent laparoscopic hysteromyoma resection.The anesthesia method of the reference group was simple intravenous anesthesia,and the anesthesia method of the observation group was intravenous combined anesthesia.Anesthesia effect,incidence of postoperative adverse reactions,stress index level and cognitive function were compared between the two groups.Results The onset time of anesthesia,postoperative recovery time and extubation time in the observation group were shorter than those in the reference group,and the difference was statistically significant(P<0.05).Before surgery,there was no statistically significant difference in MMSE scores between the two groups(P>0.05).MMSE scores of observation group were higher than those of reference group at 6 h,12 h and 3 days after extubation,and the difference was statistically significant(P<0.05).Before surgery,there was no statistically significant difference in SOD and MDA levels between the two groups(P>0.05).24 h after operation,SOD level in observation group was higher than that in reference group,MDA level was lower than that in reference group,and the difference was statistically significant(P<0.05).The incidence of adverse reactions in observation group was 8.70%(4/46)lower than that in reference group 13.04%(6/46),and the difference was not statistically significant(χ^(2)=0.449,P=0.503).Conclusion Compared with intravenous anesthesia alone,intravenous anesthesia combined with intravenous anesthesia has less effect on cognitive function in the application of laparoscopic hysteromyoma resection in elderly patients,which can improve the anesthetic effect and reduce the stress and adverse reactions of patients.