全凭静脉麻醉和吸入麻醉对老年手术患者认知功能的影响.docx

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全凭静脉麻醉和吸入麻醉对老年手术患者认知功能的影响

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【摘要】目的：分析全凭静脉麻醉和吸入麻醉对老年手术患者认知功能的影响。方法：采用双盲法随机将我院收治的60例老年手术患者随机分为对照组和观察组，对照组给予持续吸入七氟醚和50%N2O维持麻醉,观察组给予全凭静脉麻醉，采用瑞芬太尼0.05~0.2μg/kg·min和丙泊酚3~6mg/kg·h推注泵持续输注，并观察分析两种不同麻醉方式对患者的影响。结果：观察组患者术前和术后24hMMSE评分与对照组之间没有显著差异（P＞0.05），而术后1h、3h、6hMMSE评分观察组均比对照组高，两组比较P＜0.05，差异有统计学意义；同时观察组患者术后睁眼时间、拔管时间明显少于对照组，两组比较P＜0.05，差异有统计学意义。而两组患者手术麻醉时间无差异（P＞0.05）。结论：全凭静脉麻醉方式在老年腹部手术中应用，麻醉恢复快，术后清醒时间短，认知功能影响小，安全性和可行性高，值得临床推广使用。

【关键词】吸入麻醉；全凭静脉麻醉；老年手术患者

Theimpactonthecognitivefunctionofelderlypatientswithsurgerybytotalintravenousanesthesiaandinhalationanesthesia［Abstract］Objective:Toanalyzedtheimpactonthecognitivefunctionofoldpatientswithsurgerybytotalintravenousanesthesiaandinhalationanesthesia.Methods:Sixtyoldpatientswithsurgeryinourhospitalwererandomlypidedintothecontrolgroupandtheobservationgroupbyutilizingthedouble-blindmethod,thecontrolgroupmainlyweretreatedwithcontinuedsevofluraneand50%N2Ointheclinic,howeverobservationgroupreceivedtotalintravenousanesthesia,usingremifentanil0.05~0.2μg/kg·minandpropofol3~6mg/kg·hcontinuousinfusionpumpbolus,andobservedtheeffectonthepatientsofthetwodifferentanesthesiamethods.Results:Therewasnoobviouslysignificantdifference(P0.05)betweentheobservationgroupandthecontrolgroupaboutthepre-operationandpost-operation24hMMSEscore.Butthescoreofpost-operation1h,3h,6hMMSEoftheobservationgroupwashigherthanthecontrolgroup,compared,(P0.05),thedifferenceisstatisticallySignifi-cant.Meanwhilethetimeofopeningeyes,extubationobviouslywaslessthanthecontrolgroup,compared(P0.05),thedifferenceisstatisticallysignificant.andtheanesthesiatimeofthetwogroupsofpatientswasnodifference(P0.05).Conclusion:Utilizingthemethodoftotalintravenousanesthesia(TIVA)intheclinicfortheoldpatientsnotonlymakesanesthesiarecoverytimefaster,butalsocanmakesmallereffectsonthecognitivefunctionintheelderlypatients.Andtheanesthesiaeffecthashighsecurityandfeasibility,andworthyofpopularization.［Keywords］Inhalationanesthesia;Totalintravenousanesthesia;Elderlypatientswithsurgery

R2【文献标号】A