异氟醚静吸复合麻醉与持续输注丙泊酚静脉麻醉对老年患者术后认知功能的影响比较

摘要

目的：探讨持续输注丙泊酚静脉麻醉与异氟醚静吸复合麻醉对老年患者术后认知功能影响作用。方法选择我院2012年4月～2014年3月收治的78例行下腹部手术的老年患者为研究对象，随机分为异氟醚组与丙泊酚组各39例，异氟醚组吸入1～2MAC异氟醚作维持麻醉；丙泊酚组患者行丙泊酚静脉输注持续麻醉，对两组患者使用精神状态量表（MMSE），对术前及术后不同时间的状况进行评分，并观察两组患者围术期的认知功能变化相关情况。结果两组患者麻醉时间及术后恢复时间无明显差异（P＜0.05）；术前异氟醚组与丙泊酚组的MMSE评分无明显差异（P＞0.05）；术后不同时间点患者的MMSE评分对比显示，异氟醚组与丙泊酚组有明显差异（P＜0.05）；其中术后1h与术前、术后48h、72h的MMSE评分对比显示有统计学意义（P＜0.05）；术后8h的MMSE评分明显低于术前及术后48h、术后72h（P＜0.05）；异氟醚组术后MMES评分达到POCD诊断水平率显著高于丙泊酚组（P＜0.05）。结论异氟醚与丙泊酚麻醉后均会对老年患者术后短期内认知功能造成一定影响，但是异氟醚麻醉影响较大，且其持续时间较长。%Objective Discussion continuous infusion of propofol intravenous anesthesia with isoflu-rane inhalation combined anesthesia function influence on postoperative cognitive older patients. Methods Our hospital from April 2012~March 2014 78 admitted routine abdominal surgery in elderly patients in this study were randomly divided into isoflurane and propofol groups of 39 cas-es, isoflurane 1~2MAC inhaled isoflurane for maintenance of anesthesia; patients with propofol continuous infusion of propofol anesthesia, two groups of patients with Mental State Examination (MMSE), preoperative and postoperative status were different times score, and were observed peri-operative cognitive function in the relevant circumstances. Results Two groups of patients anes-thesia and postoperative recovery time was no significant difference (P<0.05); MMSE preoperative isoflurane and propofol score was no significant difference(P>0.05); patients at different time points after MMSE Rating contrast display, isoflurane and propofol group were significantly different (P<0.05); wherein after 1h preoperative and postoperative 48h, MMSE score of contrast 72h showed a statistically significant(P<0.05); 8h after the MMSE score was significantly lower than the preoper-ative and postoperative 48h, after 72h (P<0.05); isoflurane group were MMES score reached POCD diagnosis was significantly higher than propofol group (P<0.05).Conclusions Both will isoflurane and propofol anesthesia in elderly patients with postoperative cognitive function in the short term some impact, but the greater impact of isoflurane anesthesia, and its longer duration.