麻醉与脑电意识监测系统监测老年肠癌不同深度麻醉腹腔镜术后早期认知功能障碍研究

摘要

Objective:To investigate the effect of different depth of anesthesia monitoring in elderly cancer patients in the early postoperative cognitive dysfunction (POCD).Methods: 124 cases were received general anesthesia laparoscopic resection of colorectal cancer in elderly patients, and randomly divided into the observation group and the control group, each with 62 cases. The mean artery pressure (MAP) and heart rate of two groups of patients at different depth of anesthesia in each period were compared with the previous induction of anesthesia (t0), the organ before intubation (t1) and after intubation (t2), before pneumoperitoneum (t3) and after pneumoperitoneum (t4), after surgery (t5) and extubation (t6). The corresponding indexes were also compared between the two groups of patients. Results:In the control group, heart rate of t2, and t4~t6 increased significantly faster. The differences were statistically significant compared with the observation group (t=4.132,t=4.345,t=4.253,t=5.326;P<0.05). MAP parameters in the control group were significantly higher than that in the observation group and the differences were statistically significant (t=5.433, t=4.985,t=5.032,t=5.163;P<0.05). POCD in the observation group was significantly lower than that in the control group and the differences were statistically significant (x2=5.323,P<0.05).Conclusion: In elderly patients with laparoscopic colorectal surgery radical NTS will remain at D2 level, which can effectively reduce the incidence of POCD patients and help patients maintain stable hemodynamics. It is worth of further promoting in clinical.%目的：探讨麻醉与脑电意识监测系统监测不同深度麻醉对老年肠癌患者术后早期认知功能障碍(POCD)的影响效果。方法：选取124例行全身麻醉腹腔镜肠癌根治术的老年患者，根据不同麻醉深度将其分为观察组与对照组，每组62例。观察组为常规麻醉深度1级(D1)，对照组为常规麻醉深度2级(D2)，比较两组患者于不同麻醉深度下麻醉诱导前(t0)，器官插管前(t1)、插管后(t2)，气腹前(t3)、气腹后(t4)，手术结束(t5)及拔管(t6)等各时期平均动脉压(MAP)及心率；对比两组患者相应指标变化情况；进行认知功能测定。结果：对照组t2、t4～t6时间点时心率明显增快，与观察组比较有差异(t=4.132，t=4.345，t=4.253，t=5.326；P＜0.05)；对照组MAP指标明显高于观察组患者，组间比较有差异(t=5.433，t=4.985，t=5.032，t=5.163；P＜0.05)；观察组POCD发生率明显低于对照组，组间比较有差异(x2=5.323，P＜0.05)。结论：老年腹腔镜肠癌根治术中将患者延髓孤束核(NTS)维持在常规麻醉深度2级(D2)水平可有效减少患者POCD发生情况，有利于维持患者血流动力的稳定，值得临床进一步推广使用。