中国继续医学教育
中國繼續醫學教育
중국계속의학교육
China Continuing Medical Education
2015年
27期
86-87
,共2页
硬膜外麻醉%全身麻醉%认知障碍%老年人%腹腔镜%结肠肿瘤
硬膜外痳醉%全身痳醉%認知障礙%老年人%腹腔鏡%結腸腫瘤
경막외마취%전신마취%인지장애%노년인%복강경%결장종류
Epidural anesthesia%General anesthesia%Cognition disorders%Elderly%Laparoscopic%Colonic neoplasms
目的：探讨全身麻醉联合硬膜外阻滞对老年患者腹腔镜结肠癌根治术后认知功能（POCD）的影响。方法选择南阳市第一人民医院行腹腔镜结肠癌根治术的老年患者120例，将以上患者均分为观察组和对照组，对照组行常规全身麻醉，观察组行硬膜外阻滞复合全身麻醉，使用简易精神状态量表（MMSE）评价认知功能。结果两组麻醉后自主呼吸恢复时间、苏醒时间、拔管时间差异无统计学意义（P＞0.05），术后第1 d、第3 d MMSE评分两组均出现显著的减低（P＜0.05），观察组均高于对照组（P＜0.05），术后第1 d、第3 d对照组认知功能障碍（POCD）发生率均高于观察组（P＜0.05）。结论全麻联合硬膜外阻滞对腹腔镜下结肠癌根治术老年患者认知功能影响小，可降低POCD发生，具有一定的临床应用价值。
目的：探討全身痳醉聯閤硬膜外阻滯對老年患者腹腔鏡結腸癌根治術後認知功能（POCD）的影響。方法選擇南暘市第一人民醫院行腹腔鏡結腸癌根治術的老年患者120例，將以上患者均分為觀察組和對照組，對照組行常規全身痳醉，觀察組行硬膜外阻滯複閤全身痳醉，使用簡易精神狀態量錶（MMSE）評價認知功能。結果兩組痳醉後自主呼吸恢複時間、囌醒時間、拔管時間差異無統計學意義（P＞0.05），術後第1 d、第3 d MMSE評分兩組均齣現顯著的減低（P＜0.05），觀察組均高于對照組（P＜0.05），術後第1 d、第3 d對照組認知功能障礙（POCD）髮生率均高于觀察組（P＜0.05）。結論全痳聯閤硬膜外阻滯對腹腔鏡下結腸癌根治術老年患者認知功能影響小，可降低POCD髮生，具有一定的臨床應用價值。
목적：탐토전신마취연합경막외조체대노년환자복강경결장암근치술후인지공능（POCD）적영향。방법선택남양시제일인민의원행복강경결장암근치술적노년환자120례，장이상환자균분위관찰조화대조조，대조조행상규전신마취，관찰조행경막외조체복합전신마취，사용간역정신상태량표（MMSE）평개인지공능。결과량조마취후자주호흡회복시간、소성시간、발관시간차이무통계학의의（P＞0.05），술후제1 d、제3 d MMSE평분량조균출현현저적감저（P＜0.05），관찰조균고우대조조（P＜0.05），술후제1 d、제3 d대조조인지공능장애（POCD）발생솔균고우관찰조（P＜0.05）。결론전마연합경막외조체대복강경하결장암근치술노년환자인지공능영향소，가강저POCD발생，구유일정적림상응용개치。
Objective To explore the effect of general anesthesia combined with epidural anesthesia on postoperative cognitive dysfunction (POCD) in elderly colon cancer patient underwent laparoscopic radical operation. Methods 120 cases of elderly patients underwent laparoscopic radical colon cancer operation were selected in the First People's Hospital of Nanyang City, they were randomly divided into two groups of equal number, and were recorded as the observation group and the control group, the control group were anesthetized with conventional general anesthesia, and the observation group were anesthetized with general anesthesia combined with epidural anesthesia observation, the cognitive function was estimated by MMSE. ResultsThe recovery time of respiratory depression, drowsiness and extubation was no signiifcant differences between the two groups (P>0.05), The MMSE score of first days and third days after operation was decreased (P<0.05). The observation group was higher than that in the control group (P<0.05), the incidence of cognitive dysfunction (POCD) in the control group was higher than that in the observation group after ifrst days and third days after operation (P<0.05).Conclusion The general anesthesia combined with epidural anesthesia can decrease POCD in elderly colon cancer patient underwent laparoscopic radical operation, with worthy of clinical application.
