瑞芬太尼对宫颈癌根治术患者术后早期认知功能的影响

The Effect of Remifentanil on Postoperative Early Cognitive Function of Patients with Cervical Carcinoma

目的探讨瑞芬太尼对宫颈癌根治术患者术后早期认知功能的影响。方法将84例宫颈癌根治术患者,随机分为对照组(芬太尼、丙泊酚麻醉)和观察组(瑞芬太尼、丙泊酚麻醉),每组各42例,比较两组患者术后睁眼时间、拔管时间、苏醒时间,根据简易智能量表(MMSE),观察两组患者术前、术后2 h、术后4 h、术后6 h、术后1 d、术后2 d的认知功能评分变化情况,以及比较两组术后认知功能障碍发生率。结果与对照组相比,观察组术后睁眼时间、拔管时间、苏醒时间均明显缩短,P<0.05;与术前相比,两组术后2 h、术后4 h、术后6 h认知功能评分均明显降低,P<0.05;与对照组相比,观察组术后2 h、术后4 h、术后6 h、术后1 d、术后2 d认知功能评分明显升高,P<0.05;与对照组相比,观察组术后2 h、术后4 h、术后6 h、术后1 d认知功能障碍发生率均显著降低,P<0.05。结论瑞芬太尼麻醉后,宫颈癌根治术患者术后会出现短暂的认知功能障碍,但是患者术后能较快恢复,对患者认知功能影响较小,值得临床广泛推广。

Objective To study the effect of remifentanil on postoperative early cognitive function of patients with cervical carcinoma. Methods 84 patients with cervical carcinoma were randomized into the control group( anesthesia with fentanyl and propofol) and the observation group( anesthesia with remifentanil and propofol),42 patients per group. The eye opening time after operation,extubation time,awakening time in the 2 groups were compared,the scores changes of the postoperative cognitive function before operation and 2 h,4 h,6 h,1 d,2 d after operation,and the incidence of postoperative cognitive dysfunction in the2 groups were observed and compared. Results Compared with the control group,the eye opening time after operation,extubation time,awakening time in the observation group were significantly decreased( P < 0. 05); compared with before operation,the scores of the postoperative cognitive function 2 h,4 h,6 h after operation decreased obviously in the observation group( P < 0. 05); compared with the control group,the scores of the postoperative cognitive function 2 h,4 h,6 h,1 d,2 d after operation increased significantly in the observation group( P < 0. 05); compared with the control group,the incidence of postoperative cognitive dysfunction 2 h,4 h,6 h,1 d after operation decreased significantly in the observation group( P < 0. 05). Conclusion After the remifentanil anesthesia,patients with cervical carcinoma have transient cognitive dysfunction with faster recovery,it has less influence on cognitive function of patients,and it is worthy of clinical promotion.