[1]龚涛武,朱昭琼,郑雪,等.不同全身麻醉方法对腹腔镜胆囊切除术后早期认知功能的影响[J].第三军医大学学报,2013,35(01):50-53.
 Gong Taowu,Zhu Zhaoqiong,Zheng Xue,et al.Effect of different general anesthesia on early postoperative cognitive function of patients undergoing laparoscopic cholecystectomy[J].J Third Mil Med Univ,2013,35(01):50-53.
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不同全身麻醉方法对腹腔镜胆囊切除术后早期认知功能的影响(/HTML )
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
35卷
期数:
2013年第01期
页码:
50-53
栏目:
论著
出版日期:
2013-01-15

文章信息/Info

Title:
Effect of different general anesthesia on early postoperative cognitive function of patients undergoing laparoscopic cholecystectomy
作者:
龚涛武 朱昭琼 郑雪 李娟
遵义医学院附属医院麻醉科,贵州航天医院麻醉科
Author(s):
Gong Taowu Zhu Zhaoqiong Zheng Xue Li Juan
Department of Anesthesiology, Affiliated Hospital of Zunyi Medical College, Zunyi, Guizhou Province, 563000,Department of Anesthesiology, Zunyi Aerospace Hospital, Zunyi, Guizhou Province,China
关键词:
术后认知功能障碍全身麻醉
Keywords:
postoperative cognitive dysfunction general anesthesia
分类号:
R614.2; R657.4; R749
文献标志码:
A
摘要:
目的      观察不同全身麻醉方法后腹腔镜胆囊切除术(laparoscopic cholecystectomy, LC)早期认知功能的变化。      方法        51例ASAⅠ~Ⅱ级择期行LC术患者,年龄30~50岁,麻醉后归为全凭静脉麻醉组、全程吸入麻醉组、静吸复合麻醉组共3组。分别于手术前1 d、手术后第1、3、7天测定患者的简易智力状态检查(mini-mental state examination, MMSE)的评分,并比较其变化,评价POCD的发生情况及其可能的危险因素。      结果       ①手术后第1天,各麻醉组均有发生术后认知功能障碍,静吸复合麻醉组4例(17.4%),全程吸入麻醉组2例(18.2%),全凭静脉麻醉组2例(11.8%),各组间比较差异无统计学意义(P>0.05)。②3组患者术前一般情况比较,性别、年龄、身高、高血压病史、糖尿病病史、手术史均无统计学意义(P>0.05),而静吸复合麻醉组的体质量与全程吸入麻醉组和全凭静脉麻醉组比较,差异有统计学意义(P<0.05)。③3组患者围手术期变量的比较,阿托品用量、麻黄碱用量、麻醉苏醒时间、拔管时间、术后住院时间、术后恶心、呕吐发生等均无统计学意义。④3组各时间点生命体征的比较,HR与SpO2无统计学意义,而SBP与DBP于T2、T3、T4时间点,全程吸入麻醉组与静吸复合麻醉组、全凭静脉麻醉组比较差异有统计学意义(P<0.05)。⑤手术中发生低血压的例数静吸复合麻醉组2例(8.7%)、全程吸入麻醉组6例(54.5%)、全凭静脉麻醉组0例,各组间比较差异有统计学意义(P<0.05)。⑥Logistic分析显示患者发生术后短期认知功能障碍与围手术期的各变量间无相关性。      结论        不同全身麻醉方法不会增加腹腔镜胆囊切除术后POCD的发生率,对患者术后早期认知功能无明显影响。
Abstract:
Objective        To investigate the changes of early cognitive function of laparoscopic cholecystectomy (LC) patients with different general anesthesia.       Methods      Fifty-one ASA Ⅰ-Ⅱ patients of 30-50 years old who underwent selective LC were divided into an intravenous anesthesia group, an inhalation anesthesia group and an intravenous inhalational anesthesia group. Mini-mental state examination (MMSE) were examined and compared at the first day before surgery (T1), and the first day (T2), the third day (T3) and the seventh day (T4) after surgery. Then the incidence and possible risk factors of postoperative cognitive dysfunction (POCD) were evaluated.       Results       (1) At the first day after surgery, POCD occurred in all anesthesia groups, including 4 patients (17.4%) in the intravenous inhalational anesthesia group, 2 patients (18.2%) in the inhalation anesthesia group, and 2 patients (11.8%) in the intravenous anesthesia group. No significant difference existed among the 3 groups (P>0.05). (2) There was no statistically significant difference in preoperative general situation (including sex, age, body height, hypertension history, diabetes history and surgical history) among the 3 groups (P>0.05). But the body weight of patients in the intravenous inhalational anesthesia group showed statistically significant difference as compared with that in the inhalation anesthesia group and intravenous anesthesia group (P<0.05). (3) There was no statistically significant difference in perioperative variables (including the dosages of atropine and ephedrine, anesthesia awaking time, extubation time, postoperative hospital stay, and postoperative nausea and vomiting) among the 3 groups (P>0.05). (4) Comparison of vital signs at each time point showed that the differences of HR and SpO2 were not significant among the 3 groups, but the systolic blood pressure (SBP) and diastolic blood pressure (DBP) at T2, T3 and T4 in the inhalation anesthesia group were significantly different from those in the intravenous inhalational anesthesia group and intravenous anesthesia group (P<0.05). (5) The number of patients with hypotension during LC had statistically significant difference among the 3 groups, including 2 patients (8.7%) in the intravenous inhalational anesthesia group, 6 patients (54.5%) in the inhalation anesthesia group, and 0 patients in the intravenous anesthesia group (P<0.05). (6) The results of Logistic regression analysis showed no correlation between postoperative short-term cognitive dysfunction and perioperative variables.       Conclusion        Different kinds of general anesthesia do not increase the incidence of POCD, and have no significant effect on early postoperative cognitive function of patients underwent LC.

参考文献/References:

龚涛武, 朱昭琼, 郑雪,等. 不同全身麻醉方法对腹腔镜胆囊切除术后早期认知功能的影响[J].第三军医大学学报,2013,35(1):50-53.

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更新日期/Last Update: 2012-12-31