硬膜外麻醉复合全身麻醉对直肠癌根治手术患者术后认知功能的影响(1)
[摘要] 目的 探究硬膜外麻醉复合全身麻醉对直肠癌根治手术患者术后认知功能的影响。方法 方便选取从2012年6月—2016年12月在该院就诊的212例直肠癌根治术患者根据麻醉方式的不同分为对照组和实验组，对照组有86例患者，实验组有126例患者；对照组采用单纯全身麻醉方式，实验组采用硬膜外麻醉复合全身麻醉方式；对比分析两组患者MMES评分、睁眼时间、拔管时间以及应答时间。结果 ①术前两组患者MMES评分差异无统计学意义(P>0.05)；实验组患者术后6、12 h和24 h MMES评分分别为(27.6±1.2)分、(27.0±1.5)分和(29.2±0.9)分，均显著的高于对照组(P<0.05)。②实验组患者睁眼时间(11.3±2.2)min、拔管时间(13.3±2.8)min和应答时间(15.0±3.3)min，均显著的短于对照组(P<0.05)。结论 在直肠癌根治手术患者的临床治疗中，硬膜外麻醉复合全身麻醉能够有效的缓解患者术后认知功能障碍，有效缩短患者睁眼时间、拔管时间以及应答时间，在临床中具有推广应用价值。
[关键词] 直肠癌根治手术；硬膜外麻醉；全身麻醉；术后认知功能
[中图分类号] R614 [文献标识码] A [文章编号] 1674-0742(2017)07(c)-0073-03
[Abstract] Objective To study the effect of epidural anesthesia and general anesthesia on the postoperative cognitive function of patients with rectal carcinoma radical surgery. Methods 212 cases of patients with rectal carcinoma radical surgery diagnosed in our hospital from June 2012 to December 2016 were selected and divided into two groups according to the anesthesia method， the control group with 86 cases adopted the simple general anesthesia， while the experimental group with 126 cases adopted the epidural anesthesia and general anesthesia， and the MMES score， eye opening time， tube drawing time and reply time of the two groups were compared and analyzed. Results The difference in the MMES score between the two groups before surgery was not obvious(P>0.05)， and the MMES scores at 6， 12 h and 24 h after surgery in the experimental group were respectively (27.6±1.2)points， (27.0±1.5)points and (29.2±0.9)points， which were obviously higher than those in the control group(P<0.05)， and the eye opening time， tube drawing time and reply time in the experimental group were respectively (11.3±2.2)min， (13.3±2.8)min and (15.0±3.3)min， which were obviously shorter than those in the control group(P<0.05). Conclusion The epidural anesthesia and general anesthesia in the patients with rectal carcinoma radical surgery can effectively relieve the cognitive dysfunction after operation and effectively shorten the eye opening time， tube drawing time and reply time， and it is worth promotion and application in clinic.
[Key words] Rectal carcinoma radical surgery； Epidural anesthesia； General anesthesia； Postoperative cognitive function
隨着经济的发展，居民生活水平的提高，目前直肠癌根治术常选择全身麻醉来取代以往双管硬膜外阻滞的麻醉方法，能有效解决单独应用硬膜外麻醉时可能因直肠癌根治术创伤面积较大、手术时间较长，所致的麻醉效果不完善的问题。极大提高患者及手术医生的满意度[1-2]。但全身麻醉也存在着费用较高、术后认知功能障碍、对心血管造成的影响等不良反应[3-4]。近些年该院对直肠癌根治手术患者采用硬膜外复合全身麻醉方式，很好的发挥两种麻醉方法的优点，互相取长补短，克服各自的不足，取得较好的效果，现报道如下。
1 资料与方法, 百拇医药(郑得全)
[关键词] 直肠癌根治手术；硬膜外麻醉；全身麻醉；术后认知功能
[中图分类号] R614 [文献标识码] A [文章编号] 1674-0742(2017)07(c)-0073-03
[Abstract] Objective To study the effect of epidural anesthesia and general anesthesia on the postoperative cognitive function of patients with rectal carcinoma radical surgery. Methods 212 cases of patients with rectal carcinoma radical surgery diagnosed in our hospital from June 2012 to December 2016 were selected and divided into two groups according to the anesthesia method， the control group with 86 cases adopted the simple general anesthesia， while the experimental group with 126 cases adopted the epidural anesthesia and general anesthesia， and the MMES score， eye opening time， tube drawing time and reply time of the two groups were compared and analyzed. Results The difference in the MMES score between the two groups before surgery was not obvious(P>0.05)， and the MMES scores at 6， 12 h and 24 h after surgery in the experimental group were respectively (27.6±1.2)points， (27.0±1.5)points and (29.2±0.9)points， which were obviously higher than those in the control group(P<0.05)， and the eye opening time， tube drawing time and reply time in the experimental group were respectively (11.3±2.2)min， (13.3±2.8)min and (15.0±3.3)min， which were obviously shorter than those in the control group(P<0.05). Conclusion The epidural anesthesia and general anesthesia in the patients with rectal carcinoma radical surgery can effectively relieve the cognitive dysfunction after operation and effectively shorten the eye opening time， tube drawing time and reply time， and it is worth promotion and application in clinic.
[Key words] Rectal carcinoma radical surgery； Epidural anesthesia； General anesthesia； Postoperative cognitive function
隨着经济的发展，居民生活水平的提高，目前直肠癌根治术常选择全身麻醉来取代以往双管硬膜外阻滞的麻醉方法，能有效解决单独应用硬膜外麻醉时可能因直肠癌根治术创伤面积较大、手术时间较长，所致的麻醉效果不完善的问题。极大提高患者及手术医生的满意度[1-2]。但全身麻醉也存在着费用较高、术后认知功能障碍、对心血管造成的影响等不良反应[3-4]。近些年该院对直肠癌根治手术患者采用硬膜外复合全身麻醉方式，很好的发挥两种麻醉方法的优点，互相取长补短，克服各自的不足，取得较好的效果，现报道如下。
1 资料与方法, 百拇医药(郑得全)