【摘要】 目的探讨麻醉对老年消化道肿瘤患者术后早期认知功能的影响。方法回顾性分析2013年6月至2014年6月间收治的、行手术治疗的104例老年消化道肿瘤患者的临床资料,其中50例采用静吸复合全麻(A组),54例采用静吸复合全麻联合硬膜外麻醉(B组),比较两组患者的麻醉效果及术后早期认知功能情况。结果 A组的麻醉优良率为98.0%,B组为96.3%,组间差异无统计学意义(P>0.05);术前两组患者的简易智能精神状态检查量表(MMSE)评分差异无统计学意义(P>0.05)。两组患者术后3、6 h的MMSE评分较术前显著降低,差异有统计学意义(P<0.05),且A组显著低于B组,差异有统计学意义(P<0.05)。两组患者术后1、3 d的MMSE评分逐渐提高,与术前比较,差异无统计学意义(P>0.05),且组间差异无统计学意义(P>0.05)。A组患者术后3、6 h的认知障碍发生率分别为42.0%和32.0%,显著高于B组的24.1%和13.0%,差异有统计学意义(P<0.05)。结论不同麻醉方案对老年消化道肿瘤患者术后早期认知功能均存在一定的影响,会降低术后早期认知功能,但术后1~3 d均可恢复正常,可根据患者状况选择更适合的麻醉方案。更多还原

【Abstract】 Objective To investigate the effect of anesthesia on the early postoperative cognitive function in elderly digestive tract cancer. Methods From June 2013 to June 2014,the clinical data of 104 cases of elderly digestive tract cancer with surgery treatment were analyzed retrospectively,50 cases with intravenous-inhalation combined anesthesia as group A,54 cases with intravenous-inhalation combined anesthesia and epidural anesthesia as group B. The anesthetic effect and early postoperative cognitive function situation of the two groups were compared. Results The excellent rate of anesthesia excellent in group A was 98. 0%,and group B was 96. 3%,and there was no significant difference between the two groups( P >0. 05); before operation,the mini-mental state examination( MMSE) scores of two groups were compared,and the difference was not statistically significant( P > 0. 05); 3 h and 6 h after operation,the MMSE scores of the two groups were decreased significantly compared with before operation( P < 0. 05),and group A was significantly lower than group B( P < 0. 05); 1 d and 3 d after operation,the MMSE score of the two groups were gradually increased,and there was no statistically significant difference with before operation( P > 0. 05),and there was no statistically significant difference between the two groups( P > 0. 05); the patient’s cognitive disorder rates of group A after operation 3 h and 6h were 42. 0% and 32. 0%,significantly higher than 24. 1% and 13. 0% of group B,with significant difference( P < 0. 05). Conclusions Different anesthesia program for elderly digestive tract cancer have certain effects on early postoperative cognitive function. It can reduce early postoperative cognitive function,but after 1d to 3 d can return to normal.Clinicians should choose a more suitable anesthetic solution based on the patient’s condition.更多还原