重庆医学2016，Vol.45Issue(20)：2769-2771,2774,4.DOI:10.3969/j.issn.1671-8348.2016.20.010
全身麻醉方式对全子宫切除术患者术后认知功能的影响
Effect of general anesthetic mode on postoperative cognitive dysfunction in patients undergoing laparoscopic radical hysterectomy
摘要
Abstract
Objective To investigate the influence of two general anesthestic modes on postoperative cognitive dysfunction (POCD) in the patients undergoing laparoscopic radical hysterectomy .Methods One hundred ASA Ⅰ‐Ⅱ patients undergoing lapa‐roscopic radical hysterectomy were randomly allocated to the propofol group (group P) and sevoflurane group (group S) ,50 cases in each group .The anaesthesia time ,total dose of sufentanil ,total dose of vecuronium ,recovery time ,recovery time for regaining ori‐entation and complications during anesthetic recovery period were recorded .The cognitive function was assessed by the mini‐mental state examination (MMSE) on preoperative 1 d (T0 ) ,postoperative 1 d (T1 ) ,postoperative 3 d ,(T2 ) ,postoperative 7 d (T3 ) ,post‐operative 1 month (T4 )、postoperative 3 months (T5 ) and the POCD occurrence situation was evaluated by adopting the Z scoring . Results The total dose of sufentanil and vecuronium in the group S was lower than that in the group P (P<0 .05) ,the recovery time and time for regaining orientation in the group S was longer than that in the group P (P<0 .05);the incidence rates of shive‐ring ,dysphoria and upper respiratory tract obstruction in the group S were higher than those in the group P (P<0 .05) .There were no statistically significant difference in the MMSE scores between the two groups (F=0 .14 ,P=0 .709);the MMSE scores in each group had statistical differences among different time points (F=74 .46 ,P<0 .01) .The interaction effect existed between the gen‐eral anesthetic mode and time with MMSE score (F=7 .99 ,P<0 .01);the MMSE scores at T1 ,T2 in the group S were lower than those in the group P (P<0 .05) .The incidence rate of POCD at T1 ,T2 、T3 ,T4 in the group S was higher than that in the group P (P<0 .05) .Conclusion The incidence rate of POCD in the patients undergoing laparoscopic radical hysterectomy by adopting sevoflurane inhalation general anaesthesia is higher than that by adopting propofol anesthesia ,but which has no difference after postoperative 3 months .关键词
子宫切除术/腹腔镜检查/术后认知功能障碍/丙泊酚/七氟醚Key words
hysterectomy/laparoscopy/postoperative cognitive dysfunction/propofol/sevoflurane分类
医药卫生引用本文复制引用
郭翠容,陆立仁,王志强,彭志勇,郑映金..全身麻醉方式对全子宫切除术患者术后认知功能的影响[J].重庆医学,2016,45(20):2769-2771,2774,4.基金项目
广东省佛山市医学类科技攻关项目（2014AB000602）。 （）
