摘要
[目的]研究不同麻醉药物对腹腔镜胆囊切除术后早期认知功能的影响。[方法]研究对象为腹腔镜胆囊切除术患者,共188例。依据随机表法将其划分为A组(94例)、B组(94)例。A组一直吸入2.0%七氟烷,B组一直采用泵注丙泊酚。对比2组手术前、术后1 d、术后3 d简易智力状态检查量表(Mini-mental State Examination, MMSE),主要包括定向力恢复所需要时间、拔管所需要时间和患者眼睛睁开所需要时间的差别,及入室后、插管后、切除中及拔管时心率(heart rate, HR)与血氧饱和度变更状况。[结果]对比于术前,2组术后1 d MMSE评分较低(P<0.05);A组术后3 d MMSE评分基本没有变更,B组术后3 d MMSE评分较低(P<0.05);A组术后1 d、3 d MMSE的评分超过了B组(P<0.05)。A组定向力恢复时间、拔管时间和睁眼时间超过了B组(P<0.05)。2组入室后HR与血氧饱和度上差异无统计学意义(P>0.05);对比于入室数据,2组插管后、切除中HR较低(P<0.05);对比于入室后,A组拔管的HR没有较大变化(P>0.05),B组拔管时HR较低(P<0.05);对比于同期B组,A组插管后、切除中、拔管的HR较低(P<0.05)。[结论]使用七氟烷进行麻醉可以有效避免患者在手术之后产生早期的认知功能障碍,同时也不会给患者的血流动力带来较大的负面影响。
[Objective]Tocompare the effect of sevoflurane and propofol on early cognitive function after laparoscopic cholecystectomy.[Methods]A total of 188 patients admitted for laparoscopic cholecystectomy in our hospital between August 2019 and August 2020 were randomly divided into two groups: Group A(94 cases)and Group B(94 cases).Group A accept inhaled 2.0% sevoflurane, Group B propofol.The MMSE scores before surgery, one day after surgery, and 3 days after surgery, directional force recovery time, estuations time and eye opening time, and the changes of heart rate(HR)and blood oxygen saturation after entry, intubation, resection and estuations between the two groups were compared.[Results]The postoperative 1 d MMSE scores of the two groups were significantly lower than those before the operation(P<0.05).The MMSE scores of 3 d after the operation in Group B were lower while there was no difference in Group A.The MMSE scores of 1 d and 3 d after operation in Group A were higher than Group B(P<0.05).The directional force recovery time, estuations time and eye opening time in Group A were higher than those in Group B(P<0.05).There was no statistical difference in HR and oxygen saturation between the two groups after the operation(P>0.05).After intubation and resection, HR was lower in the two groups(P<0.05).After entering the room, HR of estuations showed no significant change in Group A(P>0.05),while HR of estuations was lower in Group B(P<0.05).Comparing with Group B in the same period, HR after intubation, resection and estuations were lower in Group A(P<0.05).[Conclusion]Sevoflurane can avoid early cognitive dysfunction after laparoscopic cholecystectomy without significant influence on hemodynamics, which should be further studied.
作者
项绪强
殷伟
XIANG Xu-qiang;YIN Wei(Department of Anesthesiology,Guanyun County People's Hospital,222200 Lianyungang Jiangsu,China;Department of Anesthesiology,the First Affiliated Hospital of Soochow University,215006 Suzhou,China)
出处
《临床消化病杂志》
CAS
2022年第1期17-20,共4页
Chinese Journal of Clinical Gastroenterology
基金
常州市科技计划项目(CZ2016214)。
关键词
腹腔镜胆囊切除术
麻醉药物
早期认知功能
different narcotic drugs
laparoscopic cholecystectomy
early cognitive function
