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时间:2020-04-17
《不同麻醉深度对腹腔镜胆囊切除术老年患者认知功能及应激反应的影响.pdf》由会员上传分享,免费在线阅读,更多相关内容在应用文档-天天文库。
1、·392·全科医学临床与教育2014年7月第l2卷第4期ClinicalEducationofGeneralPractice]u1.2014.Vo1.12.No.4·临床研究·不同麻醉深度对腹腔镜胆囊切除术老年患者认知功能及应激反应的影响王毅源陈元良胡崇辉[摘要]目的探讨不同麻醉深度对腹腔镜胆囊切除术老年患者认知功能及应激反应的影响。方法70例老年腹腔镜胆囊切除术患者随机分为两组,每组35例。脑电双频指数(BIS)监测麻醉深度,A组维持术中BIS在5O59.B组40~49。采用简易精神状态量表(MMSE)评估患者术前24h、拔管后1h、3
2、h和24h的认识功能,并于麻醉前、切皮前、胆囊切除时、拔管后30min检l殒l3患者血清皮质醇(Cor)、血糖(Glu)浓度和C一反应蛋白(CRP)水平。结果两组患者各时间点MMSE评分比较,差异均无统计学意义(t分别=0.41、0.15、0.43,P均>0.05);麻醉前两组患者Cor、Glu和CRP水平比较,差异均无统计学意义(f分别=O.37、0.24、0.04,P均>0.05),但B组患者麻醉后各时间.~.Cor、Glu和CRP水平均低于A组麻醉后,差异均有统计学意义(分别=3.87、4.54、3.61、2.47、3.17、3.3
3、6、3.65、5.65、6.63,P均<0.05)。结论维持术中BIS在50~59和4O一49对腹腔镜胆囊切除术老年患者认知功能的影响相当.但后者对应激反应抑制效果更好。[关键词1麻醉;腹腔镜胆囊切除术;脑电双频指数;认知功能;应激反应Efectofdiferentdepthofanesthesiaoncognitionfunctionandstressreactioninelderswithlaparoscopicchole.cystectomyWANGYiyuan,CHENYuanliang,HUChonghui.Department
4、ofAnesthesiology,CentralHospitalofJin—hua,Jinhua321000,China[Abstract]ObjectiveToexploretheeffectofdiferentdepthofanesthesiaoncognitionfunctionandstressreactioninelderswithlaparoscopiccholecystectomy.MethodsAtotalof70casesofelderlywithlaparoscopiccholecystectomywererandom
5、lydividedintotwogroupswith35caseseach.Thedepthofanesthesiawasdetectedbybispectralindex(BIS),andtheBISvaluesweremaintaining50to59ingroupAand40to49ingroupBrespectively.Cognitivefunctionsat24hoursbeforeoperarion,3hoursand24hoursafterextubationwereevaluatedbytheminimummentals
6、tateexamination(MMSE)scale.Theserumlevelsofcortisol(Cor),glucose(Glu)andC—reactionprotein(CRP)weredetectedatthetimesofbegin—ningofanesthesia,skinincision,gallbladderremovalingand30minutesafterextubation.ResultsTheMMSEscoresshowednostatisticaldifferencebetweenthetwogroupsa
7、teverypoint(t=O.41,O.15,0.43,P>0.05).ThelevelofCor,GluandCRPatbeginningofanesthesiabetweentwogroupswerenotsignificantlydiferent(t=O.37,0.24,0.04,P>0.05),butthoseingroupBwerelowerthangroupAattimesofskinincision,gallbladderremovalingand30minutesafterextubation(t=3.87,4.54,3
8、.61,2.47,3.17,3.36,3.65,5.65,6.63,P<0.05).ConclusionTheeffectofmaintainingBISat50to59and40to49we
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