目的：探讨七氟醚复合丙泊酚对老年腹腔镜胆囊切除术患者术后早期认知功能的影响。方法选取2013年5月~2014年5月在本院接受腹腔镜胆囊切除术的46例老年患者作为研究对象,随机分为试验组和对照组,各23例。对照组采用静脉全身麻醉,麻醉诱导后持续泵入丙泊酚加瑞芬太尼维持。试验组麻醉诱导后持续泵入丙泊酚并复合吸入七氟醚维持。观察两组不同时间点的心率(HR)、平均动脉压(MAP)、血氧饱和度(SpO2),记录两组的苏醒时间、拔管时间和恢复时间以及不同时间段的MMSE评分。结果两组t2时的MAP水平显著低于t1,t3时的MAP水平显著高于t1,差异有统计学意义(P<0.05)。两组各时间段的HR、MAP和SpO2水平比较,差异无统计学意义(P跃0.05)。试验组的术后麻醉苏醒时间、术后拔管时间和意识活动恢复时间显著短于对照组,差异有统计学意义(P<0.05)。试验组术后3、6、12 h的MMSE评分显著低于对照组,差异有统计学意义(P<0.05)。两组术后24、48 h的MMSE评分比较,差异无统计学意义(P跃0.05)。结论七氟醚复合丙泊酚在老年腹腔镜胆囊切除术中的麻醉效果良好,苏醒时间快,对早期认知功能无较大影响,值得临床推广应用。%Objective To explore the influence of sevoflurane combined with propofol on early cognitive function in el-derly patients with laparoscopic cholecystectomy. Methods 46 elderly patients with laparoscopic cholecystectomy from May 2013 to May 2014 in our hospital were selected and randomly divided into the experimental group and the control group,23 cases in each group.The control group was given intravenous anesthesia,and the continuous infusion of propo-fol and remifentanil was maintained after anesthesia induction.The experimental group was given continuous infusion of propofol and sevoflurane inhalation.The level of heart rate (HR),mean arterial pressure (MAP),oxygen saturation (SpO2) was observed at different time points in two groups,and the awake time,extubation time,recovery time and the MMSE scores of different time periods in two groups was recorded. Results The level of MAP at t2 in two groups was lower than that at t1,the level of MAP at t3 in two groups was higher than that at t1,with significant difference (P<0.05).There was no significant difference in the level of HR,MAP,SpO2 at each time point between two groups (P>0.05).The awake time,extubation time and recovery time in the experimental group was shorter than that in the control group,with signifi-cant difference (P<0.05).The score of MMSE after operation at 3,6,12 h in the experimental group was lower than that in the control group,with significant difference (P<0.05).There was no significant difference in the score of MMSE after operation at 24,48 h between two groups (P>0.05). Conclusion The anesthetic effect of sevoflurane combined with propofol in elderly patients with laparoscopic cholecystectomy is good,and the recovery time is fast,which has no effect on early cognitive function,it is worthy of clinical promotion and application.
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