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的影响(1)

http://www.100md.com 2018年3月5日 《中国医学创新》 2018年第7期

     【摘要】 目的：将全身麻醉联合硬膜外阻滞应用于老年患者腹腔镜结肠癌根治术中，对其术后认知功能影响进行討论。方法：选取2016年6月-2017年3月本院就诊行腹腔镜结肠癌根治术患者47例，按照随机数字表法分成研究组24例和对照组23例。研究组给予全身麻醉联合硬膜外阻滞，对照组给予全身麻醉，所有患者均行腹腔镜结肠癌根治术。对比分析两组麻醉相关指标、精神状态评分(MMSE评分)、认知功能障碍发生率等。结果：研究组拔管时间、自主呼吸恢复时间及苏醒时间等指标数据均明显短于对照组，研究组术后第1、3天的MMSE评分均高与对照组，研究组术后第1、3天认知功能障碍发生率明显低于对照组，比较差异均有统计学意义(P<0.05)，研究组麻醉效果更好。结论：将全身麻醉联合硬膜外阻滞应用于老年患者腹腔镜结肠癌根治术中，在达到预期麻醉效果的同时有效控制患者术后认知功能的影响，临床应用价值明显。

    【关键词】 老年患者； 结肠癌根治术； 全身麻醉； 硬膜外阻滞； 认知功能影响

    Investigation The Effect of General Anesthesia Combined with Epidural Blockade on Cognitive Function of Elderly Patients in Laparoscopic Radical Operation for Carcinoma of Colon/YAN Yan.//Medical Innovation of China，2018，15(07)：133-136
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    【Abstract】 Objective：To observe the effect of general anesthesia combined with epidural blockade on cognitive function of elderly patients in laparoscopic radical operation for carcinoma of colon.Method：A total of 47 cases which were treat by laparoscopic radical operation for carcinoma of colon in our hospital from June 2016 to March 2017 were divided into study group of 24 cases and control group of 23 cases according to table of random numbers.The study group was received general anesthesia combined with epidural blockade，the control group was received general anesthesia，all patients were treated by laparoscopic radical operation for carcinoma of colon. Anesthesia related indicators，mental state score (MMSE score)，the incidence of cognitive dysfunction were compared between two groups.Result：The extubation time，spontaneous breathing recovery time and recovery time in the study group were shorter than those in the control group，the MMSE score on the first day and the third day in the study group were higher than those in the control group，the incidence of cognitive dysfunction on the first day and the third day after operation in the study group was significantly lower than that in the control group，the differences were statistically significant(P<0.05).Conclusion：The application of general anesthesia combined with epidural block for elderly patients in laparoscopic radical operation for carcinoma of colonachieve the desired affect of anesthesia，effectively control the impact of postoperative cognitive function and has great clinical value.

    【Key words】 Elderly patients； Radical colon cancer； General anesthesia； Epidural blockade； Cognitive effects

    First-author’s address：Huizhou Central People’s Hospital，Huizhou 516001，China

    doi：10.3969/j.issn.1674-4985.2018.07.038, 百拇医药(严俨)

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