瑞芬太尼复合异丙酚全凭静脉麻醉对老年患者术后认知功能影响分析.docVIP

瑞芬太尼复合异丙酚全凭静脉麻醉对老年患者术后认知功能影响分析 　　DOI：10.16662/j.cnki.1674-0742.2017.25.134 　　[摘要] 目的 探?瑞芬太尼复合异丙酚全凭静脉麻醉对老年患者术后认知功能的影响。方法 方便选取2016年4月―2017年4月在该院行妇科盆腔手术的120例老年患者随机分为两组，对照组采用芬太尼联合丙泊酚麻醉，观察组采用瑞芬太尼复合异丙酚麻醉，比较术后知障碍发生率、MMSE评分、全麻恢复时间。结果 观察组术后3、6、24、48 h认知障碍发生率为3.33%、1.67%、0.00%、0.00%明显低于对照组的21.67%、16.67%、10.00%、5.00%（P0.05）；观察组术后3、6、24、48 h MMSE评分分为别（23.55±3.24）分、（25.76±2.32）分、（27.89±0.35）分、（27.92±0.24）分明显高于对照组的（20.12±3.16）分、（23.09±1.04）分、（25.01±0.31）分、（25.62±0.57）分（P0.05）；观察组睁眼时间（3.98±1.06）min、自主呼吸恢复时间（10.18±3.24）min、拔管时间（11.03±3.21）min、定向力恢复时间（9.86±2.57）min明显较对照组的（7.25±1.39）、（18.22±3.17）、（21.16±3.26）、（13.42±4.09）min短（P0.05）。结论 瑞芬太尼复合异丙酚全凭静脉麻醉对老年患者术后认知功能影响较小，能够缩短术后麻醉恢复时间，提升苏醒质量，减少认知障碍的发生率。 　　[关键词] 全凭静脉麻醉；瑞芬太尼复合异丙酚；术后认知功能 　　[中图分类号] R614 [文献标识码] A [文章编号] 1674-0742（2017）09（a）-0134-03 　　Effect of Remifentanil Combined with Propofol on Total Intravenous Anesthesia on Postoperative Cognitive Function of Elderly Patients 　　ZHOU Min， ZHANG Li， WANG Jing 　　Department of Anesthesiology， Fujian Provincial Maternity and Child Care Center， Fuzhou， Fujian Province， 350001 China 　　[Abstract] Objective This paper tries to investigate the effect of remifentanil combined with propofol on postoperative cognitive function in elderly patients. Methods 120 elderly patients underwent gynecological pelvic surgery in this hospital from April 2016 to April 2017 were randomly divided into two groups， the control group received fentanyl combined with propofol total intravenous anesthesia treatment， the observation group received remifentanil combined with propofol total intravenous anesthesia treatment， and then the occurance rate of cognitive barriers， MMSE score， total anesthesia recovery time of the two groups were compared. Results The incidence of cognitive impairment after 3 hours， 6 hours， 24 hours and 48 hours in the observation group was 3.33%， 1.67%， 0.00% and 0.00% respectively， significantly lower than that in the control group of 21.67%， 16.67%， 10.00%， 5.00%（P 　　[Key words] Total