目的：探讨脑电双频指数监测对全身麻醉老年患者术后认知功能障碍的影响。方法选择我院2012-01-2012-12收治的择期在全麻下行上腹部手术的老年患者82例，随机分为观察组和对照组，每组41例，对照组采用常规麻醉，观察组采用BIS麻醉把控。观察患者心率（HR）、平均动脉压（MAP）变化情况，麻醉期间丙泊酚用量，手术时间、拔管时间、清醒时间及认知功能障碍发生情况。结果2组患者诱导时平均动脉压均有所下降，其他各时点2组患者 HR、MAP检测值差异无统计学意义（ P＞0.05）；观察组丙泊酚用量（678±78）m g ，显著低于对照组（823±97）m g ，差异有统计学意义（ P＜0.05）；2组患者手术时间差异无统计学意义（P＞0.05），但观察组拔管时间（9±3）min及清醒时间（13±4）min显著早于对照组（26±8）min、（21±6）min ，差异有统计学意义（P＜0.05）；2组患者术前及术后24 h的MMSE评分差异无统计学意义（P＞0.05）；但观察组术中（24.12±1.7）分，显著高于对照组（21.96±1.8）分，差异有统计学意义（ P＜0.05）。结论麻醉过程中采用脑电双频指数监测，可显著提高麻醉镇静深度判断的准确性，有效降低老年患者术后认知功能障碍的发生。%Objective To investigate and analyze the impact of bispectral index monitoring on postoperative cognitive dys-function of elderly patients with general anesthesia .Methods 82 cases of elderly patients under general anesthesia for abdomi-nal surgery from January 2012 to December 2012 admitted to our hospital were randomly divided into two groups ,the observa-tion group and the control group ,41 patients each group .the control group was given conventional anesthesia ;in the observa-tion group ,BIS was used to monitor the effectiveness of general anesthesia .Heart rate (HR) ,mean arterial pressure (MAP) changes ,the dosage of propofol during anesthesia ,operative time ,extubation time ,recovery time and incidence of cognitive dysfunction were observed and recorded .Results In the two groups ,mean arterial pressure induced by anesthesia has declined somewhat ;at each other time point ,the difference of HR and MAP between two groups was not statistically significant (P>0 .05);The dosage of propofol in observation group (678 ± 78) mg was significantly lower than that of the control group (823 ± 97) mg ,the difference was statistically significant (P<0 .05);Operative time of the two groups was of no significant differ-ence (P>0 .05) ,but the extubation time (9 ± 3 ) min and awake time (13 ± 4) min of the observation group were significantly earlier than (26 ± 8) and (21 ± 6) min (26 ± 8) of the control group ,the difference was statistically significant (P<0 .05);MMSE scores before and after 24h of surgery of the two groups was of no statistically significant difference (P>0 .05);how-ever MMSE scores during operation in the observation group (24 .12 ± 1 .7) was significantly higher (21 .96 ± 1 .8) than that of the control group ,the difference was statistically significant (P< 0 .05).Conclusion using bispectral index monitor during general anesthesia is instrumental to accurately judge the depth of sedation and effectively reduce the incidence of postoperative cognitive dysfunction in elderly patients .
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