不同麻醉药对老年肺癌患者术后认知功能的影响

Effects of Different Anesthetic Drugs on Cognitive Function of Elderly Patients with Lung Cancer after Operation

目的探讨丙泊酚和七氟醚对老年肺癌患者术后认知功能的影响。方法选取2012年2月-2014年2月拟行手术治疗的Ⅰ~Ⅱ级肺癌患者64例,随机分为丙泊酚组和七氟醚组,每组各32例。丙泊酚组和七氟醚组分别使用丙泊酚和七氟醚进行全身麻醉。记录各组患者自主呼吸恢复时间、呼之睁眼时间和定向力恢复时间,并使用简易精神状态量表(mini-mental state examination,MMSE)和视觉模拟评分法(visual analogue score,VAS)对患者认知功能和疼痛进行评估。结果丙泊酚组呼吸恢复时间、呼之睁眼时间、定向力恢复时间与七氟醚组比较,P<0.05,差异具有统计学意义。丙泊酚组术后6 h、12 h、24 h的MMSE评分与术前比较,P<0.05,差异具有统计学意义;七氟醚组术后6 h、12 h、24h、3 d的MMSE评分与术前比较,P<0.05,差异具有统计学意义。丙泊酚组术后6 h、术后12 h MMSE评分与七氟醚组比较,P<0.05,差异具有统计学意义。结论丙泊酚对老年肺癌患者术后认知功能的影响小,患者术后苏醒快。

Objective To investigate the effects of propofol and sevoflurane on cognitive function of elderly patients with lung cancer after operation. Methods 64 cases of lung cancer patients underwent surgical operation were randomly divided into the propofol group and the sevoflurane group,32 patients in each group. The propofol group and sevoflurane group used propofol and sevoflurane for general anesthesia,respectively. Spontaneous breathing recovery time,called the open time and recovery time were recorded,and cognitive function and pain were evaluated by mini-mental state examination( MMSE) and visual analogue score( VAS). Results Breathing recovery time,called the open time and recovery time of orientation between the propofol group and sevoflurane group had statistical difference,P < 0. 05; postoperative and preoperative 6 h,12 h and 24 h MMSE score in the propofol group had statistical difference,P < 0. 05; postoperative and preoperative 6 h,12 h,24 h and 3 d MMSE score in the sevoflurane group had statistical difference,P < 0. 05; postoperative 6 h and 12 h MMSE score between the propofol group and sevoflurane group had statistical difference,P < 0. 05. Conclusion Effect of propofol on the cognitive function of postoperative elderly patients with lung cancer is slight,and it has faster postoperative recovery.