瑞芬太尼和异丙酚全凭静脉麻醉对老年腹腔镜下胆囊切除术后认知功能的影响

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摘要目的探讨瑞芬太尼和异丙酚全凭静脉麻醉对老年腹腔镜下胆囊切除术后认知功能的影响。方法选取本院2015年6月～2016年12月收治的84例进行腹腔镜下胆囊切除术的老年患者，随机分成两组，各42例。其中对照组患者采用七氟醚静吸复合麻醉，实验组患者采用瑞芬太尼和异丙酚全凭静脉麻醉，观察两组患者的麻醉效果及对认知功能的影响。结果手术后，两组患者的手术时间、拔管时间差异无统计学意义（P＞0.05），实验组的苏醒时间、自主恢复呼吸时间和定向力恢复时间均显著短于对照组（P＜0.05）；除了拔管24 h后两组患者意识状态差异无统计学意义（P＞0.05）外，其余时间段实验组患者的意识状态均显著优于对照组（P＜0.05）；除了术前24 h和拔管24 h后两组患者认知功能差异无统计学意义（P＞0.05）外，其余时间段实验组患者的认知功能均显著优于对照组（P＜0.05）。结论瑞芬太尼和异丙酚全凭静脉麻醉应用于老年腹腔镜下胆囊切除术后可提高患者术中生命体征平稳程度，有效减轻患者的应激反应，且能达到显著的认知功能恢复效果，值得临床广泛推广。

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关键词 ：瑞芬太尼, 异丙酚, 全凭静脉麻醉, 胆囊切除术

Abstract：ObjectiveTo explore the influence of Remifentanil and Propofol for total intravenous anesthesia on cognitive function in elderly patients undergoing laparoscopic cholecystectomy.Methods84 elderly patients given laparoscopic cholecystectomy in our hospital from June 2015 to December 2016 were selected and randomly divided into two groups, and there were 42 cases in each group.The control group was given Sevoflurane for balance anesthesia,while the experimental group was given Remifentanil and Propofol for total intravenous anesthesia.The anesthetic effect and its influence on cognitive function of the two groups were observed.ResultsAfter operation,the operation time,extubation time between two groups had no statistical difference (P>0.05),while the recovery time,spontaneous breathing and the recovery time of directive force in the experimental group were significantly shorter than those of the control group(P<0.05). In addition to there was no statistical difference(P>0.05)of conscious state 24 hours after extubation,then at other time slot,the conscious state in the experimental group were significantly better than those of the control group (P<0.05).In addition there was no significant difference (P>0.05)between the cognitive function of two groups of patients before 24 hours and 24 hours after extubation (P>0.05),and at other time slot,cognitive function in the experimental group were significantly better than those of the control group(P<0.05).ConclusionRemifentanil and Propofol for total intravenous anesthesia applied in elderly patients undergoing laparoscopic cholecystectomy can increase the stable degree of vital signs during operation and effectively reduce the stress of patients,and can achieve significant effect on the recovery of cognitive function,and it is worthy of clinical wide promotion.

Key words： Remifentanil Propofol Total intravenous anesthesia Cholecystectomy

引用本文:

徐建立. 瑞芬太尼和异丙酚全凭静脉麻醉对老年腹腔镜下胆囊切除术后认知功能的影响[J]. 中国当代医药, 2017, 24(14): 103-105.
XU Jian-li. Influence of Remifentanil and Propofol for total intravenous anesthesia on cognitive function in elderly patients undergoing laparoscopic cholecystectomy. 中国当代医药, 2017, 24(14): 103-105.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2017/V24/I14/103

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