中国现代医生
中國現代醫生
중국현대의생
CHINA MODERN DOCTOR
2014年
25期
57-59,63
,共4页
丙泊酚%芬太尼%瑞芬太尼%老年%苏醒%认知功能
丙泊酚%芬太尼%瑞芬太尼%老年%囌醒%認知功能
병박분%분태니%서분태니%노년%소성%인지공능
Propofol%Fentanyl%Remifentanil%Senile%Revival%Cognitive function
目的：探讨丙泊酚与芬太尼或瑞芬太尼复合麻醉对老年全身麻醉后苏醒时间及认知功能的影响。方法选取72例老年全身麻醉手术患者，用随机数字表将纳入的72例老年全身麻醉手术患者分为观察组(n=36)和对照组(n=36)。观察组采用丙泊酚与瑞芬太尼复合麻醉，对照组采用丙泊酚与芬太尼复合麻醉。观察两组患者麻醉后苏醒时间及认知功能的变化。结果与对照组比较，观察组患者麻醉后自主呼吸恢复时间、呼之睁眼时间、拔管时间以及定向力恢复时间均偏短(P<0.05或P<0.01)。麻醉前两组患者MMSE评分之间比较差异不明显(P>0.05)。麻醉后两组患者MMSE评分在6h和12h时均有不同程度的下降(P<0.05或P<0.01)，且观察组下降值明显小于观察组(P<0.05)，麻醉后24h两组患者MMSE评分均上升至麻醉前水平(P>0.05)。结论丙泊酚与瑞芬太尼复合麻醉患者麻醉后苏醒较丙泊酚与芬太尼复合麻醉更快，能明显缩短患者的气管插管时间，减少患者术后苏醒监护时间，且对老年患者麻醉后早期认知功能的影响较少。
目的：探討丙泊酚與芬太尼或瑞芬太尼複閤痳醉對老年全身痳醉後囌醒時間及認知功能的影響。方法選取72例老年全身痳醉手術患者，用隨機數字錶將納入的72例老年全身痳醉手術患者分為觀察組(n=36)和對照組(n=36)。觀察組採用丙泊酚與瑞芬太尼複閤痳醉，對照組採用丙泊酚與芬太尼複閤痳醉。觀察兩組患者痳醉後囌醒時間及認知功能的變化。結果與對照組比較，觀察組患者痳醉後自主呼吸恢複時間、呼之睜眼時間、拔管時間以及定嚮力恢複時間均偏短(P<0.05或P<0.01)。痳醉前兩組患者MMSE評分之間比較差異不明顯(P>0.05)。痳醉後兩組患者MMSE評分在6h和12h時均有不同程度的下降(P<0.05或P<0.01)，且觀察組下降值明顯小于觀察組(P<0.05)，痳醉後24h兩組患者MMSE評分均上升至痳醉前水平(P>0.05)。結論丙泊酚與瑞芬太尼複閤痳醉患者痳醉後囌醒較丙泊酚與芬太尼複閤痳醉更快，能明顯縮短患者的氣管插管時間，減少患者術後囌醒鑑護時間，且對老年患者痳醉後早期認知功能的影響較少。
목적：탐토병박분여분태니혹서분태니복합마취대노년전신마취후소성시간급인지공능적영향。방법선취72례노년전신마취수술환자，용수궤수자표장납입적72례노년전신마취수술환자분위관찰조(n=36)화대조조(n=36)。관찰조채용병박분여서분태니복합마취，대조조채용병박분여분태니복합마취。관찰량조환자마취후소성시간급인지공능적변화。결과여대조조비교，관찰조환자마취후자주호흡회복시간、호지정안시간、발관시간이급정향력회복시간균편단(P<0.05혹P<0.01)。마취전량조환자MMSE평분지간비교차이불명현(P>0.05)。마취후량조환자MMSE평분재6h화12h시균유불동정도적하강(P<0.05혹P<0.01)，차관찰조하강치명현소우관찰조(P<0.05)，마취후24h량조환자MMSE평분균상승지마취전수평(P>0.05)。결론병박분여서분태니복합마취환자마취후소성교병박분여분태니복합마취경쾌，능명현축단환자적기관삽관시간，감소환자술후소성감호시간，차대노년환자마취후조기인지공능적영향교소。
Objective To discuss influence of combined anesthesia of propofol and fentanyl or remifentanil on revival time and cognitive function of senile patients treated with general anesthesia. Methods A total of 72 cases of senile patients were selected and divided into observation group(n=36 cases)and control group(n=36 cases) by table of ran-dom number. The patients in observation group were given propofol and remifentanil, while the patients in control group were given combined anesthesia of propofol and fentanyl. The changes of revival time and cognitive function of patients in two groups after the anesthesia were observed and compared. Results The spontaneous breathing recovery time,eyes-open time,time of extubation and orientation recovery time of patients in observation group after the anes-thesia were all much shorter than those in control group (P<0.05 or P<0.01). After comparing the MMSE scores of pa-tients in two groups before anesthesia, no statistical differences appeared (P>0.05). The MMSE scores at 6 and 12 hours after the anesthesia obviously declined than before(P<0.05 or P<0.01),and the declining rate of patients in ob-servation group was much lower than that in observation group (P<0.05). The MMSE score at 24 hours after the anes-thesia came back to the same level as that before anesthesia(P>0.05). Conclusion Compared with combined anesthesia of propofol and fentanyl, the revival time, tracheal intubation time and postoperative recovery monitoring time of pa-tients,who are given the combined anesthesia of propofol and remifentanil,are all much shorter,and the influence on cognitive function after anesthesia is much smaller for senile patients.
