深度中度和浅度麻醉对老年全身麻醉患者术后认知功能影响对比.docVIP

深度中度和浅度麻醉对老年全身麻醉患者术后认知功能影响对比 　　[摘要]目的 探?深度、中度和浅度麻醉对老年全身麻醉患者术后认知功能的影响。方法 选取2014年2月～2017年2月于我院进行全身麻醉下择期胃肠道肿瘤手术的69例老年患者，随机分为L组、M组及D组，各23例。L组行浅度麻醉，M组行中度麻醉，D组行深度麻醉。比较三组的麻醉时间、补液量、出血量、定向力恢复时间以及不同时期的心率（HR）、平均动脉压（MAP）、POCD发生率、和手术前后的MMSE评分。结果 三组的麻醉时间、补液量、出血量比较，差异无统计学意义（P0.05）。D组的定向力恢复时间显著长于L组和M组，差异有统计学意义（P0.05）。三组插管前、术中1 h及术中2 h的HR、MAP均显著低于诱导前，差异有统计学意义（P0.05）。结论 对老年全身麻醉患者而言，深度麻醉能够有效降低老年患者的POCD发生率，相对于其他麻醉深度而言，其对患者的认知功能会影响较小。 　　[关键词]麻醉深度；认知功能；全身麻醉 　　[中图分类号] R614.2 [文献标识码] A [文章编号] 1674-4721（2017）06（b）-0120-04 　　[Abstract]Objective To explore the influence of depth，moderate and superficial anesthesia on postoperative cognitive function in elderly patients undergoing general anesthesia.Methods 69 elderly patients scheduled to undergo elective gastrointestinal tumor surgery under general anesthesia in our hospital from February 2014 to February 2017 were selected and randomly divided into group L，group M and group D，23 cases in each group.Group L was given superficial anesthesia，group M was given moderate anesthesia，and group D was given deep anesthesia.The time of anesthesia，the amount of fluid infusion，the amount of bleeding，the recovery time of the directional force，the heart rate （HR），the mean arterial pressure （MAP），the incidence rate of POCD and the MMSE score before and after the operation were compared between the three groups.Results There was no significant difference in the time of anesthesia，the amount of fluid infusion and the amount of bleeding between the three groups （P0.05）.The recovery time of directional force in group D was significantly longer than that in group L and group M，with significant difference （P0.05）.The level of HR and MAP before intubation，1 hour and 2 hours during the operation in the three groups were significantly lower than those before induction，with significant difference （P0.05）.Conclusion For elderly patients with general anesthesia，deep anesthesia can effectively reduce the incidence rate of POCD in elderly patients，compared with oth