不同麻醉方式对老年肺癌患者术后认知功能的影响

doi:10.11904/j.issn.1002-3070.2018.05.009

实用肿瘤学杂志 ›› 2018, Vol. 32 ›› Issue (5): 432-436.doi: 10.11904/j.issn.1002-3070.2018.05.009

不同麻醉方式对老年肺癌患者术后认知功能的影响

钟雪莱, 杨海粒, 王国年

哈尔滨医科大学附属肿瘤医院麻醉科(哈尔滨 150081)

收稿日期:2018-04-11 出版日期:2018-10-28 发布日期:2018-10-23
通讯作者: 王国年,E-mail:wangguonian609cn@aliyun.com
作者简介:钟雪莱,女,(1991-),硕士研究生,从事麻醉手术创伤、免疫和癌痛治的研究。

Effects of different anesthesia methods on postoperative cognitive function in elderly patients with lung cancer

ZHONG Xuelai, YANG Haili, WANG Guonian

Department of Anesthesiology,Harbin Medical University Cancer Hospital,Harbin 150081,China

Received:2018-04-11 Online:2018-10-28 Published:2018-10-23

摘要/Abstract

摘要： 目的探讨全身麻醉和全身麻醉复合椎旁阻滞麻醉对肺癌开胸手术患者血流动力学和术后认知功能的影响。方法选取我院近两年行肺癌手术的老年肺癌患者100例,年龄65~75岁,随机将其分为对照组和观察组,对照组应用全身麻醉方式(n=50),观察组应用全身麻醉复合椎旁阻滞麻醉方式(n=50)。分别观察并记录两组患者术中以及术后的血流动力学变化。比较手术前后患者的简易精神状态量表评分法(MMSE)评分、睁眼时间、拔管时间以及应答时间。结果观察组术中及术后血流动力学变化较对照组平稳(P＜0.05);术前两组患者的MMSE评分无统计学差异,术后观察组患者MMSE评分高于对照组(P＜0.05)。对照组睁眼时间为(34.8±10.5)min,拔管时间为(34.1±6.5)min,应答时间为(38.9±9.6)min,观察组上述指标分别为(30.2±10.3)min、(30.3±7.4)min和(33.6±9.6)min,观察组术后睁眼时间、拔管时间、应答时间与对照组相比明显缩短,差异有统计学意义(P＜0.05)。结论全身麻醉复合椎旁阻滞麻醉与全身麻醉相比,对患者的生命体征影响更小,发生术后认知功能障碍的机率更少。

关键词: 全身麻醉, 椎旁阻滞, 肺癌患者, 认知功能

Abstract: Objective The aim of this study was to evaluate effects of general anesthesia and general anesthesia combined with paravertebral block(PVB)anesthesia on hemodynamics and postoperative cognitive function in elderly patients undergoing lung thoracotomy.Methods A total of 100 elderly patients who underwent lung cancer surgery in our hospital for the past two years were selected and aged 65~75 years old.The patients were randomly divided into the control and the observation groups.The control group was treated with general anesthesia(n=50).The observation group was applied to general anesthesia combined with PVB anesthesia(n=50).The hemodynamic changes of control and observation groups were observed and recorded during and after anesthesia.The Mini-mental State Examination(MMSE)score,eye opening time,extubation time and response time were compared before and after surgery.Results The hemodynamics changes in the observation group during and after operation were more stable than that in the control group(P＜0.05).There was no significant difference in the MMSE scores between the control and observation groups before operation.The MMSE scores in patients after surgery in the observation group were higher than that in the control group(P＜0.05).In the control group,the eye opening time was(34.8±10.5)min,extubation time was(34.1±6.5)min,and response time was(38.9±9.6)min.The observation group was(30.2±10.3)min,(30.3±7.4)min,and(33.6±9.6)min,in eye opening time,extubation time and response time,respectively.They were significantly decreased in the observation group than those in the control group(P＜0.05).Conclusion Compared to general anesthesia,the general anesthesia combined with PVB anesthesia has a smaller impact on the patient′s vital signs and less chance of postoperative cognitive impairment.

Key words: General anesthesia, Paravertebral block, Lung cancer, Cognitive function

中图分类号:

R734.2

钟雪莱, 杨海粒, 王国年. 不同麻醉方式对老年肺癌患者术后认知功能的影响[J]. 实用肿瘤学杂志, 2018, 32(5): 432-436.

ZHONG Xuelai, YANG Haili, WANG Guonian. Effects of different anesthesia methods on postoperative cognitive function in elderly patients with lung cancer[J]. PRACTICAL ONCOLOGY JOURNAL, 2018, 32(5): 432-436.

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不同麻醉方式对老年肺癌患者术后认知功能的影响

Effects of different anesthesia methods on postoperative cognitive function in elderly patients with lung cancer

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