CAJ | 학술논문

目的：探讨七氟醚吸入全麻和椎管内麻醉对老年泌尿外科手术患者认知功能的影响。方法研究68例择期泌尿手术的老年患者随机均分为七氟醚吸入全麻组（A组）和椎管内麻醉组（B组），分别记录两组麻醉时间、手术出血量、术中输液量、低血压和低氧血症发生次数，同时采用简易精神状况检查量表（MMSE）评估两组患者麻醉前1d及术后1d、3d、7d的认知功能。结果两组麻醉时间、手术出血量、术中输液量、低血压和低氧血症发生次数比较差异无统计学意义（P>0.05）。两组术后1d、3d的MMSE评分均明显低于手术前，且A组显著低于B组，差异均具有统计学意义（P<0.05）；A组术后7 d的MMSE评分显著低于手术前，但与对照组比较差异无统计学意义（P>0.05）；A组术后1d及3d的POCD发生率均明显高于B组，具有统计学意义（P<0.05），而两组术后7d 的POCD发生率差异无统计学意义（P>0.05）。结论七氟醚吸入全麻较椎管内麻醉对老年泌尿外科手术患者更易发生认知功能障碍。
목적：탐토칠불미흡입전마화추관내마취대노년비뇨외과수술환자인지공능적영향。방법연구68례택기비뇨수술적노년환자수궤균분위칠불미흡입전마조（A조）화추관내마취조（B조），분별기록량조마취시간、수술출혈량、술중수액량、저혈압화저양혈증발생차수，동시채용간역정신상황검사량표（MMSE）평고량조환자마취전1d급술후1d、3d、7d적인지공능。결과량조마취시간、수술출혈량、술중수액량、저혈압화저양혈증발생차수비교차이무통계학의의（P>0.05）。량조술후1d、3d적MMSE평분균명현저우수술전，차A조현저저우B조，차이균구유통계학의의（P<0.05）；A조술후7 d적MMSE평분현저저우수술전，단여대조조비교차이무통계학의의（P>0.05）；A조술후1d급3d적POCD발생솔균명현고우B조，구유통계학의의（P<0.05），이량조술후7d 적POCD발생솔차이무통계학의의（P>0.05）。결론칠불미흡입전마교추관내마취대노년비뇨외과수술환자경역발생인지공능장애。
Objective To observe the effects of sevoflurane inhalation anesthesia and spinal canal anesthesia on cogni-tive function in patients with urinary surgery in the elderly. Methods Researched 68 patients that undergoing elective urinary surgery in elderly patients, and then randomly divided into the sevoflurane inhalation anesthesia group (group A) and spinal canal anesthesia group (group B). The two groups were recorded time of anesthesia operation, surgical blood loss and transfusion volume, low blood pressure and the number of hypoxemia occurred, at last used the simple mental state examination (MMSE) to evaluate two groups of patients with 1 d before anesthesia and postoperative 1 d, 3 d, 7 d cognitive function. Results Two groups of anesthesia operation in time, surgical blood loss and transfusion volume, low blood pressure and the number of hypoxemia occurred had no significant differences(P>0.05). Two groups of postoper-ative 1 d, 3 d MMSE score were significantly lower than before operation, and the group A was significantly lower than group B, the differences were statistically significant(P <0.05);MMSE of A group ofter treatment for 7days were signifi-cantly lower than before the operation, but there was no significant difference compared with controls of groupA ofter treatment for 7 days (P>0.05); The incidence of POCD postoperative 1 d and 3 d in groupA were significantly higher than that of group B, with significant difference (P<0.05), and the incidence of POCD difference of two groups of post-operative 7 d was not significant (P >0.05). Conclusion Sevoflurane inhalation anesthesia is spinal canal anesthesia cognitive dysfunction occurred more often in patients with elderly urinary surgery.