期刊文献+

麻醉与脑电意识监测系统监测老年肠癌不同深度麻醉腹腔镜术后早期认知功能障碍研究 被引量:15

Early studies of cognitive dysfunction after narcotrend monitoring different depth of anesthesia of elderly patients with colorectal cancer
下载PDF
导出
摘要 目的:探讨麻醉与脑电意识监测系统监测不同深度麻醉对老年肠癌患者术后早期认知功能障碍(POCD)的影响效果。方法:选取124例行全身麻醉腹腔镜肠癌根治术的老年患者,根据不同麻醉深度将其分为观察组与对照组,每组62例。观察组为常规麻醉深度1级(D1),对照组为常规麻醉深度2级(D2),比较两组患者于不同麻醉深度下麻醉诱导前(t_0),器官插管前(t_1)、插管后(t_2),气腹前(t_3)、气腹后(t_4),手术结束(t_5)及拔管(t_6)等各时期平均动脉压(MAP)及心率;对比两组患者相应指标变化情况;进行认知功能测定。结果:对照组t_2、t_4~t_6时间点时心率明显增快,与观察组比较有差异(t_=4.132,t_=4.345,t_=4.253,t_=5.326;P<0.05);对照组MAP指标明显高于观察组患者,组间比较有差异(t_=5.433,t_=4.985,t_=5.032,t_=5.163;P<0.05);观察组POCD发生率明显低于对照组,组间比较有差异(x^2=5.323,P<0.05)。结论:老年腹腔镜肠癌根治术中将患者延髓孤束核(NTS)维持在常规麻醉深度2级(D_2)水平可有效减少患者POCD发生情况,有利于维持患者血流动力的稳定,值得临床进一步推广使用。 Objective: To investigate the effect of different depth of anesthesia monitoring in elderly cancer patients in the early postoperative cognitive dysfunction(POCD). Methods: 124 cases were received general anesthesia laparoscopic resection of colorectal cancer in elderly patients, and randomly divided into the observation group and the control group, each with 62 cases. The mean artery pressure(MAP) and heart rate of two groups of patients at different depth of anesthesia in each period were compared with the previous induction of anesthesia(t0), the organ before intubation(t1) and after intubation(t2), before pneumoperitoneum(t3) and after pneumoperitoneum(t4), after surgery(t5) and extubation(t6). The corresponding indexes were also compared between the two groups of patients. Results: In the control group, heart rate of t2, and t4~t6 increased significantly faster. The differences were statistically significant compared with the observation group(t=4.132, t=4.345, t=4.253, t=5.326; P〈0.05). MAP parameters in the control group were significantly higher than that in the observation group and the differences were statistically significant(t=5.433, t=4.985, t=5.032, t=5.163; P〈0.05). POCD in the observation group was significantly lower than that in the control group and the differences were statistically significant(x~2=5.323, P〈0.05). Conclusion: In elderly patients with laparoscopic colorectal surgery radical NTS will remain at D_2 level, which can effectively reduce the incidence of POCD patients and help patients maintain stable hemodynamics. It is worth of further promoting in clinical.
作者 高宇
出处 《中国医学装备》 2016年第8期75-78,共4页 China Medical Equipment
关键词 Narcotrend监测 麻醉深度 认知功能障碍 腹腔镜 Narcotrend monitoring Depth of anesthesia Cognitive dysfunction Laparoscopy
  • 相关文献

参考文献11

二级参考文献96

  • 1王英,孙成英.老年食管癌术后认知障碍及治疗需求变化调查[J].中国老年保健医学,2007,5(2):17-19. 被引量:13
  • 2王云,岳云.麻醉深度监测的进展和展望[J].继续医学教育,2006,20(15):1-10. 被引量:3
  • 3Robinson TN,Eiseman B.Postoperative delirium in the elderly:diagnosis and management[J].Clin Interv Aging,2008,3(2):351-355.
  • 4Monk TG,Weldon BC,Garvan CW,et al.Predictors of cognitive dysfunction after major noncardiac surgery[J].Anesthesiology,2008,108(1):18-30.
  • 5Liu YH,Wang DX,Li LH,et al.The effects of cardiopulmonary bypass on the number of cerebral microemboli and the incidence of cognitive dysfunction after coronary artery bypass graft surgery[J].Anesth Analg,2009,109(4):1013-1022.
  • 6Van Dijk D,Spoor M,Hijman R,et al.Cognitive and cardiac outcomes 5 years after off-pump vs on-pump coronary artery bypass graft surgery[J].JAMA,2007,297(7):701-708.
  • 7Gao L,Taha R,Gauvin D,et al.Postoperative cognitive dysfunction after cardiac surgery[J].Chest,2005,128(5):3664-36670.
  • 8McKhann GM,Grega MA,Borowicz LM Jr,et al.Is there cognitive decline 1 year after CABG? Comparison with surgical and nonsurgical controls[J].Neurology,2005,65(7):991-999.
  • 9Jensen BO,Hughes P,Rasmussen LS,et al.Cognitive outcomes in elderly high-risk patients after off-pump versus conventional coronary artery bypass grafting:a randomized trial[J].Circulation,2006,113(24):2790-2795.
  • 10Culley DJ,Xie Z,Crosby G.General anesthetic-induced neurotoxicity:an emerging problem for the young and old?[J].Curr Opin Anaesthesiol,2007,20(5):408-413.

共引文献230

同被引文献112

二级引证文献42

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部