创伤与急诊电子杂志
創傷與急診電子雜誌
창상여급진전자잡지
Journal of Trauma and Emergency (Electronic Version)
2014年
4期
38-40,37
,共4页
依达拉奉%预处理%认知功能评分%老年患者
依達拉奉%預處理%認知功能評分%老年患者
의체랍봉%예처리%인지공능평분%노년환자
Edaravone%Pretreatment%Cognition function score%Aged patient
目的：评价依达拉奉预处理对全麻老年患者术后认知功能评分的影响。方法选择全麻患者90例，性别不限，年龄65~80岁，体重48~79kg，ASA分级Ⅱ或Ⅲ级，采用随机数字表法，将患者分为3组：对照组（C组）、依达拉奉30mg组（D1组）和依达拉奉60mg组（D2组），每组30例。麻醉诱导前将依达拉奉单次剂量30mg、60mg分别加入250ml生理盐水静脉输注，输注时间为20分钟，C组给予等容量生理盐水。采用近红外光谱（near infrared reflectance spectroscopy technique，NIRS）监测术前、手术结束后6小时（T1）、12小时（T2）、1天（T3）、3天（T4）、7天（T5）的脑组织氧饱和度（rSO2）。并于术前1天和术后7天采用简易智能量表（mini mental state examination，MMSE）、蒙特利尔认知评估量表（Montreal Cognitive Assessment，MoCA）对患者进行认知功能测试，记录术后认知功能障碍（postoperative cognitive dysfunction，POCD）的发生情况。结果与C组比较，D1组和D2组rSO2、MMSE、MoCA评分升高(P<0.05)，D1组和D2组间上述指标差异无统计学意义（P>0.05）。结论依达拉奉预处理可以显著提高脑组织氧饱和度，改善全麻老年患者术后认知功能评分，有助于减少老年患者POCD的发生。
目的：評價依達拉奉預處理對全痳老年患者術後認知功能評分的影響。方法選擇全痳患者90例，性彆不限，年齡65~80歲，體重48~79kg，ASA分級Ⅱ或Ⅲ級，採用隨機數字錶法，將患者分為3組：對照組（C組）、依達拉奉30mg組（D1組）和依達拉奉60mg組（D2組），每組30例。痳醉誘導前將依達拉奉單次劑量30mg、60mg分彆加入250ml生理鹽水靜脈輸註，輸註時間為20分鐘，C組給予等容量生理鹽水。採用近紅外光譜（near infrared reflectance spectroscopy technique，NIRS）鑑測術前、手術結束後6小時（T1）、12小時（T2）、1天（T3）、3天（T4）、7天（T5）的腦組織氧飽和度（rSO2）。併于術前1天和術後7天採用簡易智能量錶（mini mental state examination，MMSE）、矇特利爾認知評估量錶（Montreal Cognitive Assessment，MoCA）對患者進行認知功能測試，記錄術後認知功能障礙（postoperative cognitive dysfunction，POCD）的髮生情況。結果與C組比較，D1組和D2組rSO2、MMSE、MoCA評分升高(P<0.05)，D1組和D2組間上述指標差異無統計學意義（P>0.05）。結論依達拉奉預處理可以顯著提高腦組織氧飽和度，改善全痳老年患者術後認知功能評分，有助于減少老年患者POCD的髮生。
목적：평개의체랍봉예처리대전마노년환자술후인지공능평분적영향。방법선택전마환자90례，성별불한，년령65~80세，체중48~79kg，ASA분급Ⅱ혹Ⅲ급，채용수궤수자표법，장환자분위3조：대조조（C조）、의체랍봉30mg조（D1조）화의체랍봉60mg조（D2조），매조30례。마취유도전장의체랍봉단차제량30mg、60mg분별가입250ml생리염수정맥수주，수주시간위20분종，C조급여등용량생리염수。채용근홍외광보（near infrared reflectance spectroscopy technique，NIRS）감측술전、수술결속후6소시（T1）、12소시（T2）、1천（T3）、3천（T4）、7천（T5）적뇌조직양포화도（rSO2）。병우술전1천화술후7천채용간역지능량표（mini mental state examination，MMSE）、몽특리이인지평고량표（Montreal Cognitive Assessment，MoCA）대환자진행인지공능측시，기록술후인지공능장애（postoperative cognitive dysfunction，POCD）적발생정황。결과여C조비교，D1조화D2조rSO2、MMSE、MoCA평분승고(P<0.05)，D1조화D2조간상술지표차이무통계학의의（P>0.05）。결론의체랍봉예처리가이현저제고뇌조직양포화도，개선전마노년환자술후인지공능평분，유조우감소노년환자POCD적발생。
Objective To evaluate the effects of edaravone pretreatment on postoperative cognitive function scores in elderly patients undergoing general anesthesia.Method Ninety ASA physical statusⅡorⅢ patients,aged 65~80y,weighing 48~79kg,scheduled for elective surgery under general anesthesia,were randomly assigned into 3 groups(n=30,respectively):groupC(control group),group D1(edaravone 30mg group) and group D2(edaravone 60mg group).Patients were treated intravenously with edaravone 30mg(group D1 ) or 60mg(group D2 ) in 20min before anesthesia,and control group(group C) were treated with normal saline. Near infrared spectroscopy (NIRS) was used to monitor the brain tissue oxygen saturation(rSO2) of patients 1d before surgery and 6h(T1),12h(T2),1d(T3),3d(T4),7d(T5) after surgery. The cognitive function was evaluated by Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) at 1d before and 7d after operation. The development of POCD was recorded.Result Compared with group C,the rSO2,MMSE,MoCA scores were significantly increased in group D1 and D2,and no significant differences were found in the indices mentioned above between D1 and D2 groups.Conclusion Edaravone pretreatment can significantly improve rSO2, postoperative cognitive function score and might prevent the development of POCD in the elderly patients undergoing general anesthesia.
