七氟醚吸入全麻和椎管内麻醉对老年泌尿外科手术患者认知功能的影响.pdf

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1、中国现代医生2014年5月第52卷第14期·临床麻醉·七氟醚吸入全麻和椎管内麻醉对老年泌尿外科手术患者认知功能的影响蔡云亮王新潘春杰朱红陈文深圳市龙岗区人民医院麻醉科，广东深圳518172【摘要】目的探讨七氟醚吸人全麻和椎管内麻醉对老年泌尿外科手术患者认知功能的影响。方法研究68例择期泌尿手术的老年患者随机均分为七氟醚吸入全麻组(A组)和椎管内麻醉组(B组)，分别记录两组麻醉时间、手术出血量、术中输液量、低血压和低氧血症发生次数，同时采用简易精神状况检查量表(MMSE)评估两组患者麻醉前1d及术后1d、3d、7d的认知功

2、能。结果两组麻醉时间、手术出血量、术中输液量、低血压和低氧血症发生次数比较差异无统计学意义(P>0．05)。两组术后ld、3d的MMSE评分均明显低于手术前，且A组显著低于B组，差异均具有统计学意义(PO．05)：A组术后1d及3d的POCD发生率均明显高于B组，具有统计学意义(P<0．05)，而两组术后7d的POCD发生率差异无统计学意义(P>0．05)。结论七氟醚吸人全麻较椎管内麻醉对老年泌尿外科手术患者更易发生认知功能障碍。

3、【关键词】七氟醚；吸入全麻；椎管内麻醉；老年；泌尿外科手术；认知功能【中图分类号】R614【文献标识码】B【文章编号】1673—9701(2014)14-0079-03Theefectsofsevofluraneinhalationanesthesiaandspinalcanalanesthe-siaoncognitivefunctioninpatients、thurinarysurgeryintheelderlyCAIYunliangWANGXinPANChu~ieZHUHongCHENWenDepartmentofA

4、nesthesiology，LonggangDistrictPeople’SHospitalofShenzhenCity，Shenzhen518172，China[Abstract]ObjectiveToobservetheeffectsofsevofluraneinhalationanesthesiaandspinalcanalanesthesiaoncogni—tivefunctioninpatientswithurinarysurgeryintheelderly．MethodsResearched68patient

5、sthatundergoingelectiveurinarysurgeryinelderlypatients，andthenrandomlydividedintothesevofluraneinhalationanesthesiagroup(groupA)andspinalcanalanesthesiagroup(groupB)．Thetwogroupswererecordedtimeofanesthesiaoperation，surgicalbloodlossandtransfusionvolume，lowbloodp

6、ressureandthenumberofhypoxemiaoccurred，atlastusedthesimplementalstateexamination(MMSE)toevaluatetwogroupsofpatientswith1dbeforeanesthesiaandpostoperative1d，3d，7dcognitivefunction．ResultsTwogroupsofanesthesiaoperationintime，surgicalbloodlossandtransfusionvolume，to

7、wbloodpressureandthenumberofhypoxemiaoccurredhadnosignificantdifferences(P>0．05)．Twogroupsofpostoper-ative1d，3dMMSEscoreweresignificantlylowerthanbeforeoperation，andthegroupAwassignificantlylowerthangroupB，thedifferenceswerestatisticallysignificant(P<0．05)；MMSEof

8、Agroupoftertreatmentfor7daysweresignifi—cantlylowerthanbeforetheoperation，buttherewasnosignificantdifferencecomparedwithcontrolsofgroupAofertreatmentfor7days(P