CAJ | 학술논문

目的：探讨脑电双频指数监测对全身麻醉老年患者术后认知功能障碍的影响。方法选择我院2012-01-2012-12收治的择期在全麻下行上腹部手术的老年患者82例，随机分为观察组和对照组，每组41例，对照组采用常规麻醉，观察组采用BIS麻醉把控。观察患者心率（HR）、平均动脉压（MAP）变化情况，麻醉期间丙泊酚用量，手术时间、拔管时间、清醒时间及认知功能障碍发生情况。结果2组患者诱导时平均动脉压均有所下降，其他各时点2组患者 HR、MAP检测值差异无统计学意义（ P＞0.05）；观察组丙泊酚用量（678±78）m g ，显著低于对照组（823±97）m g ，差异有统计学意义（ P＜0.05）；2组患者手术时间差异无统计学意义（P＞0.05），但观察组拔管时间（9±3）min及清醒时间（13±4）min显著早于对照组（26±8）min、（21±6）min ，差异有统计学意义（P＜0.05）；2组患者术前及术后24 h的MMSE评分差异无统计学意义（P＞0.05）；但观察组术中（24.12±1.7）分，显著高于对照组（21.96±1.8）分，差异有统计学意义（ P＜0.05）。结论麻醉过程中采用脑电双频指数监测，可显著提高麻醉镇静深度判断的准确性，有效降低老年患者术后认知功能障碍的发生。
목적：탐토뇌전쌍빈지수감측대전신마취노년환자술후인지공능장애적영향。방법선택아원2012-01-2012-12수치적택기재전마하행상복부수술적노년환자82례，수궤분위관찰조화대조조，매조41례，대조조채용상규마취，관찰조채용BIS마취파공。관찰환자심솔（HR）、평균동맥압（MAP）변화정황，마취기간병박분용량，수술시간、발관시간、청성시간급인지공능장애발생정황。결과2조환자유도시평균동맥압균유소하강，기타각시점2조환자 HR、MAP검측치차이무통계학의의（ P＞0.05）；관찰조병박분용량（678±78）m g ，현저저우대조조（823±97）m g ，차이유통계학의의（ P＜0.05）；2조환자수술시간차이무통계학의의（P＞0.05），단관찰조발관시간（9±3）min급청성시간（13±4）min현저조우대조조（26±8）min、（21±6）min ，차이유통계학의의（P＜0.05）；2조환자술전급술후24 h적MMSE평분차이무통계학의의（P＞0.05）；단관찰조술중（24.12±1.7）분，현저고우대조조（21.96±1.8）분，차이유통계학의의（ P＜0.05）。결론마취과정중채용뇌전쌍빈지수감측，가현저제고마취진정심도판단적준학성，유효강저노년환자술후인지공능장애적발생。
Objective To investigate and analyze the impact of bispectral index monitoring on postoperative cognitive dys-function of elderly patients with general anesthesia .Methods 82 cases of elderly patients under general anesthesia for abdomi-nal surgery from January 2012 to December 2012 admitted to our hospital were randomly divided into two groups ,the observa-tion group and the control group ,41 patients each group .the control group was given conventional anesthesia ;in the observa-tion group ,BIS was used to monitor the effectiveness of general anesthesia .Heart rate (HR) ,mean arterial pressure (MAP) changes ,the dosage of propofol during anesthesia ,operative time ,extubation time ,recovery time and incidence of cognitive dysfunction were observed and recorded .Results In the two groups ,mean arterial pressure induced by anesthesia has declined somewhat ;at each other time point ,the difference of HR and MAP between two groups was not statistically significant (P>0 .05);The dosage of propofol in observation group (678 ± 78) mg was significantly lower than that of the control group (823 ± 97) mg ,the difference was statistically significant (P<0 .05);Operative time of the two groups was of no significant differ-ence (P>0 .05) ,but the extubation time (9 ± 3 ) min and awake time (13 ± 4) min of the observation group were significantly earlier than (26 ± 8) and (21 ± 6) min (26 ± 8) of the control group ,the difference was statistically significant (P<0 .05);MMSE scores before and after 24h of surgery of the two groups was of no statistically significant difference (P>0 .05);how-ever MMSE scores during operation in the observation group (24 .12 ± 1 .7) was significantly higher (21 .96 ± 1 .8) than that of the control group ,the difference was statistically significant (P< 0 .05).Conclusion using bispectral index monitor during general anesthesia is instrumental to accurately judge the depth of sedation and effectively reduce the incidence of postoperative cognitive dysfunction in elderly patients .