Objective To investigate the effect of clinical anesthesia depth on stress reaction and neurological function in patients. Methods Take 200 cases of elderly patients which is underwent surgery from January to June in 2015 ~2016 year in our hospital as the research object. According to the depth of anesthesia, they were divided into A (light degree, the standard is 56 ~ 65), B (moderate, the standard is 46~55), C (depth, the standard is 35~45). MAP, HR, SpO2were recorded before induc-tion of anesthesia (T0), under surgery (T1) and 1 days after the end of surgery (T2) at different time points. The concentrations of plasma Cor, ACTH, ET-1, TNF-, IL-6 and CRP were detected at various time points, and 3D nerve function evaluation was performed respectively. Results The MAP and HR indexes of patients in group B and C at T1 and T2 were significantly higher than A group at T0, and there was statistical significance. The HR of patients in group B and C at T0 and T1 was significantly higher than A group, and it was statistically significant. At T1 and T2, the MAP and HR indexes of groups B and C were lower than group A, and the difference was statistically significant. The Cor, ACTH, ET-1, CRP and TNF-a indexes in the three groups were significantly higher than those at T0. The group A was significantly higher than group B and the group C. The in-dexes of Cor and ET-1 in group C was significantly lower than the group A and group B after operation. The indexes of CRP and TNF- alpha in the group B and group C were significantly lower than those in the group A. The MMSE score in the C group 1 days after operation and 3 days after surgery was significantly lower than group A. Conclusion The depth of moderate anesthe-sia can inhibit the stress reaction and avoid the excessive inhibition of circulatory function in elderly patients.%目的:探讨临床麻醉深度对患者应激反应及神经功能的影响.方法:选择200例于2015年1月~2016年6月在我院择期行全麻手术的老年患者为研究对象,根据麻醉深度的不同分为A(浅度,标准为56~65)、B(中度,标准为46~55)、C(深度,标准为35~45)组.记录患者麻醉诱导前(T0)、手术中(T1)、手术结束后1天(T2)各时间点的MAP、HR、SpO2,对各时间点血浆Cor、ACTH、ET-1、TNF-α、IL-6和CRP浓度进行检测,分别进行3d神经功能评估.结果:A组患者T1和T2时的MAP和HR指标明显高于T0时间的,有统计学意义.B组患者T1时的HR明显高于T0时,有统计学意义.在T1和T2时,B、C两组的MAP、HR指标均比A组低,有统计学意义.三组患者手术后的Cor、ACTH、ET-1、CRP和TNF-a指标均与T0相比较均显著提高,且A组显著高于B组、C组.在Cor、ET-1两个指标中,C组在手术后均显著低于A组、B组.在CRP、TNF-α两个指标中,B组、C组在手术后均显著低于A组.术后1天,术后3天的C组患者MMSE得分与A组相比,明显降低.结论:中度麻醉深度在抑制机体应激反应的同时,避免了麻醉药物对老年患者循环功能的抑制过度情况.
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