摘要
目的:探讨静吸复合麻醉与单纯静脉麻醉对子宫肌瘤腹腔镜切除术对老年患者认知功能及应激指标影响。方法:本院2018年1月30日—2019年5月30日行腹腔镜下子宫肌瘤切除术的100例老年患者,年龄≥65岁,随机数表法分为复合麻醉组(接受静吸复合麻醉)和单纯麻醉组(接受单纯静脉麻醉),每组50例。监测麻醉诱导前即刻(T0)、建立气腹前(T1)、建立气腹后(T2)、术后24h(T3)的心率(HR)、平均动脉压(MAP)、中心静脉压(CVP)。观察并比较两组苏醒指标及手术指标、不良反应发生情况。检测两组患者术后24h后外周血SOD、MDA水平。评估患者认知功能。结果:两组患者T0、T1、T2、T3时刻HR、MAP、CVP无差异,苏醒指标(苏醒时间、定向力恢复时间、恢复自主呼吸时间)及手术指标(手术时间、术中出血量)无差异(均P>0.05)。复合麻醉组术后24h SOD水平高于单纯麻醉组,MDA低于单纯麻醉组(P<0.05)。拔管后1h、6h,复合麻醉组认知功能评分高于单纯麻醉组(P<0.05)。两组不良反应发生率(4%、4%)无差异(P>0.05)。结论:静吸复合麻醉可改善腹腔镜老年子宫肌瘤切除术患者认知功能及氧化应激水平,且不影响血流动力学,安全性高。
Objective:To investigate the influence of inhaled combined intravenous anesthesia and simple intravenous anesthesia on cognitive function and stress index of elderly patients during undergone laparoscopic uterine myomectomy.Methods:100 elderly patients(≥65 years old)who had undergone laparoscopic uterine myomectomy were selected in this stugy from January 30,2018 to May 30,2019.The patients were randomly divided into two groups(50 cases in each group)by random numbers table.During laparoscopic uterine myomectomy,the patients in the control group were treated by intravenous anesthesia alone,and the patients in the observation group were treated by inhaled combined intravenous anesthesia.The heart rate(HR),mean arterial pressure(MAP),and central venous pressure(CVP)immediately of patients before induction of anesthesia(T0),pre-pneumoperitoneum(T1),at establishment of pneumoperitoneum(T2),and at postoperative 24h(T3)were monitored.The awakening indicators,surgical indicators,and adverse reactions situation of patients were observed and compared between the two groups.The levels of SOD and MDA in peripheral blood of patients in both groups at 24 hours after operation were measured.And the cognitive function of all patients was assessed.Results:There were no significant different in values of HR,MAP and CVP of patients at T0,T1,T2 and T3 between the two groups(P>0.05).There were no significant different in awakening indexes,such as awakening time,time of orientation recovery and time of spontaneous breathing recovery,and operation time,and intraoperative blood loss of patients between the two groups(P>0.05).The level of SOD at 24 h after operation of patients in the observation group was significant higher than that of patients in the control group,but the MDA level was significant lower(P<0.05).The cognitive function score of the patients in the observation group at 1h and 6h after extubation was significant higher than that of patients in the control group(P<0.05).There was no significant different in the incidence of adverse reactions of women(4%VS.4%)between the two groups(P>0.05).Conclusion:Inhaled combined intravenous anesthesia used during laparoscopic uterine myomectomy of elderly patients can improve the cognitive function and oxidative stress of patients,but don’t influent the hemodynamics of patients,which has high safety.
作者
陈靖军
赵向波
勾志静
韩雪萍
CHEN Jingjun;ZHAO Xiangbo;GOU Zhijing;HAN Xueping(The First Affiliated Hospital of Henan University of Science and Technology, Luoyang, Henan Province, 471000;The First Affiliated Hospital of Zhengzhou University)
出处
《中国计划生育学杂志》
2020年第1期76-79,共4页
Chinese Journal of Family Planning
关键词
老年妇女
腹腔镜子宫肌瘤切除术
静吸复合麻醉
单纯静脉麻醉
认知功能
应激指标
Elder women
Laparoscopic
Inhaled combined intravenous anesthesia
Simple intravenous anesthesia
Cognitive function
Stress index
