【摘要】 目的 探讨异丙酚和七氟醚麻醉对老年肺结核患者胸腔镜术后认知功能的影响。方法 选取2015年1月至2017年6月新疆维吾尔自治区胸科医院择期行肺结核胸腔镜手术老年患者60例为研究对象,按照随机数字表法将入组患者分为采用七氟醚行麻醉手术组(七氟醚组,30例)和采用异丙酚行麻醉手术组(异丙酚组,30例)。采用简易智力状态检查量表(MMSE)评估两组患者术前,以及术后2h、4h、6h、3d的认知功能变化情况,同时记录清醒质量相关指标(轻唤睁眼时间、清醒时间和拔管时间)的差异。结果 七氟醚组术后2h、4h、6h、3d的MMSE评分分别为(16.6±2.5)分、(18.7±2.8)分、(20.3±2.1)分、(24.8±1.0)分,均明显高于异丙酚组[(13.3±1.6)分、(15.3±2.2)分、(18.4±3.2)分、(23.8±1.5)分](t=6.09,P=0.000;t=5.23,P=0.000;t=2.72,P=0.009;t=2.95,P=0.005);且七氟醚组术后轻唤睁眼时间[(8.5±1.7)min]、清醒时间[(15.3±2.8)min]、拔管时间[(13.2±2.6)min]均明显短于异丙酚组[(9.7±1.2)min,(17.2±3.2)min,(15.8±2.5)min](t值分别为4.47、3.46、5.58,P值均=0.000)。结论 七氟醚复合麻醉对老年肺结核患者胸腔镜术后认知功能的影响弱于异丙酚复合麻醉,且可缩短术后苏醒时间。更多还原

【Abstract】 Objective To explore the influence of propofol and sevoflurane anesthesia on the cognitive function in elder pulmonary tuberculosis(PTB)patients after thoracoscopic surgery. Methods Sixty elder PTB patients who underwent video-assisted thoracic surgery from January 2015 to June 2017 were selected and randomly divided into sevoflurance group(n=30)and propofol group(n=30).Mini-mental State Examination(MMSE)was used to evaluate the changes of patients’ cognitive function before surgery,2,4,6 hours and 3 days after surgery.At the same time the differences in the indicators of wakefulness quality were recorded. Results The MMSE scores at 2,4,6 hours and 3 days after surgery of the patients in sevofluraneat group were 16.6±2.5,18.7±2.8,20.3±2.1 and 24.8±1.0 respectively,which were significantly higher than propofol group(13.3±1.6,15.3±2.2,18.4±3.2 and 23.8±1.5)(t=6.09,P=0.000;t=5.23,P=0.000;t=2.72,P=0.009;t=2.95,P=0.005).Time to eye opening,time to recover consciousness,time for removal of the endotracheal tube were significantly shorter in sevoflurane group((8.5±1.7)min,(15.3±2.8)min and(13.2±2.6)min)than propofol group((9.7±1.2)min,(17.2±3.2)min and(15.8±2.5)min)(t values were 4.47,3.46 and 5.58,all P=0.000).Conclusion The influence of sevoflurane is weaker than propofol combined anesthesia on the cognitive function of elder PTB patients after thoracoscopic surgery,and it can also shorten the recovery time after surgery.更多还原