七氟醚与丙泊酚麻醉对老年胃癌手术患者免疫及认知功能影响.docVIP

七氟醚与丙泊酚麻醉对老年胃癌手术患者免疫及认知功能的影响 　　[摘要] 目的 探讨七氟醚与丙泊酚麻醉对老年胃癌患者免疫功能及认知功能的影响。 方法 选取2014年3月～2016年3月中国医科大学附属第一医院收治的90例老年胃癌患者，年龄64～74岁，体重52～65 kg，美国麻醉医师协会（ASA）分级Ⅰ～Ⅱ级。采用随机数字表法将其分为七氟醚组与丙泊酚组，每组各45例。七氟醚组给予七氟醚复合芬太尼麻醉，丙泊酚组给予丙泊酚复合芬太尼麻醉。比较两组患者不同时间点免疫功能指标、MMSE认知功能评分变化及各项手术相关指标。 结果 两组患者术后6 h CD3+、CD4+及CD4+/CD8+水平较诱导前明显降低，差异均有统计学意义（P 0.05）。两组患者术后6 h MMSE评分较诱导前降低，丙泊酚组MMSE评分低于七氟醚组，差异均有统计学意义（P 0.05）。丙泊酚组睁眼时间、自主呼吸时间及拔管时间均较七氟醚组明显缩短（P 0.05）。 结论 七氟醚与丙泊酚均会对老年胃癌患者的认知功能及免疫功能指标造成短暂的影响，但丙泊酚对认知功能的影响程度更小，二者免疫功能指标及MMSE评分在术后72 h内恢复至术前水平。 　　[关键词] 麻醉药；吸入；七氟醚；丙泊酚；胃癌；免疫功能；认知功能 　　[中图分类号] R614.2 [文献标识码] A [文章编号] 1674-4721（2016）08（a）-0069-04 　　[Abstract] Objective To explore the effect of Sevoflurane and Propofol anesthesia on immune function and cognitive function of elderly patients with gastric cancer. Methods Ninety elderly patients with gastric cancer from March 2014 to March 2016 treated in the First Hospital Affiliated to China Medical University were selected， aged from 64 to 74， body mass was 52-65 kg， the American society of anesthesiologists （ASA） was Ⅰ-Ⅱ. All the patients were divided into Sevoflurane group and Propofol group according to the random number table， with 45 cases in each group. Patients of the Sevoflurane group were accepted Sevoflurane combined with fentanyl for anesthesia， patients of the Propofol group were accepted Propofol compound Fentanyl anesthesia. The immune function index， MMSE score of cognitive function and all the indexes related to the operation of the two groups were compared. Results Compared with before induction， levels of CD3+， CD4+ and CD4+/CD8+ were decreased 6 h after operation， the differences were statistically significant （P 0.05）. The MMSE score of two groups 6 h after operation were decreased compared with before induction， and MMSE score of the Propofol group 6 h after operation was obviously lower than the Sevoflurane group， the differences were statistically significant （P 0.05）. The eye opening time， spontaneous breathing time and extubation