CAJ | 학술논문

背景：近年来，无痛内镜检查后24 h内不能驾车的规定受到越来越多的质疑。目的：探讨无痛内镜检查对术后早期认知功能的影响。方法：随机选取至少接受9年义务教育、进行无痛上消化道内镜检查（ EGD）的患者100例，100例进行普通EGD检查的患者作为对照组。丙泊酚麻醉或内镜操作前以数字连接试验-A（ NCT-A）、数字划消试验和数字符号试验（ DST）进行认知功能测试，达到离院标准时重复上述测试，如结果劣于检查前，静息30 min后进行第三次测试，直至结果恢复至或优于检查前水平。结果：200例患者均完成前两次测试，124例完成第三次测试。达到离院标准时，无痛EGD组数字划消试验结果显著劣于检查前（ P=0.000）；进一步按年龄段分组，青年组数字划消试验结果显著劣于检查前（P=0.000），老年组NCT-A结果显著劣于检查前（P=0.025）；普通EGD对照组3项测试结果均不劣于检查前。完成第三次测试者各项测试结果均恢复至或优于检查前水平。结论：丙泊酚无痛内镜检查可影响患者的术后早期认知功能，但此种影响可通过适当延长离院时间得以恢复。患者的最适离院时间以及多久后方可驾车有待进一步研究确定。
배경：근년래，무통내경검사후24 h내불능가차적규정수도월래월다적질의。목적：탐토무통내경검사대술후조기인지공능적영향。방법：수궤선취지소접수9년의무교육、진행무통상소화도내경검사（ EGD）적환자100례，100례진행보통EGD검사적환자작위대조조。병박분마취혹내경조작전이수자련접시험-A（ NCT-A）、수자화소시험화수자부호시험（ DST）진행인지공능측시，체도리원표준시중복상술측시，여결과렬우검사전，정식30 min후진행제삼차측시，직지결과회복지혹우우검사전수평。결과：200례환자균완성전량차측시，124례완성제삼차측시。체도리원표준시，무통EGD조수자화소시험결과현저렬우검사전（ P=0.000）；진일보안년령단분조，청년조수자화소시험결과현저렬우검사전（P=0.000），노년조NCT-A결과현저렬우검사전（P=0.025）；보통EGD대조조3항측시결과균불렬우검사전。완성제삼차측시자각항측시결과균회복지혹우우검사전수평。결론：병박분무통내경검사가영향환자적술후조기인지공능，단차충영향가통과괄당연장리원시간득이회복。환자적최괄리원시간이급다구후방가가차유대진일보연구학정。
Background:It is commonly recommended that patients should refrain from driving for 24 hours after sedation for endoscopy,however,this recommendation has been queried recently. Aims:To investigate the effect of sedation on early postoperative cognitive function in patients undergoing endoscopy. Methods:One hundred adult patients undergoing sedative esophagogastroduodenoscopy ( EGD ) were randomly recruited, and another 100 adult patients undergoing conventional EGD were served as controls. All patients had an education level more than 9 years. Cognitive function was assessed by number connection test-A( NCT-A),number cancellation test and digit symbol test( DST)before propofol sedation or the beginning of endoscopic procedure and was reassessed when the discharge criteria were met. If the results obtained were inferior to those before EGD,a third assessment was taken 30 minutes later until the results recovered or being superior to the baseline levels. Results:All patients completed the first and second assessment,and 124 patients had taken the third assessment. When the discharge criteria were met,result of number cancellation test was inferior to that before EGD in sedation group( P =0. 000 ). Furthermore,the results were analyzed by grouping with age,number cancellation test in young patients and NCT-A in elderly patients were inferior to that before EGD,respectively(P=0. 000 and P =0. 025 ). In control group,none of the results were inferior to those before EGD. The results of the third assessment recovered or being superior to the baseline levels. Conclusions:Early postoperative cognitive dysfunction at discharge is common in patients undergoing endoscopy using propofol sedation,but the impairment will recover by a prolonged staying calm before discharge. The optimal time for discharge and resuming driving remains to be further studied.