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七氟醚联合丙泊酚用于老年胆囊切除术患者术后恢复质量及早期认知功能的变化

Changes of recovery quality and early cognitive function after treatment of sevoflurane combined with propofol in the elderly undergoing cholecystectomy.

作者信息

Shen Yading, Liu Yu, Wu Yandan, He Jie

机构信息

Department of Anesthesiology, Yiwu Central Hospital Yiwu 322000, Zhejiang Province, China.

Department of Anesthesiology, Zhuji People's Hospital of Zhejiang Province Zhuji 311800, Zhejiang Province, China.

出版信息

Am J Transl Res. 2021 Oct 15;13(10):11868-11874. eCollection 2021.

Abstract

OBJECTIVE

To explore the application value of sevoflurane + propofol in elderly patients undergoing cholecystectomy.

METHODS

A total of 121 elderly patients undergoing cholecystectomy in our hospital from February 2017 to March 2020 were enrolled. Among them, 58 patients were assigned to Group A given, anesthesia with sevoflurane during operation, and 63 patients to Group B who were given anesthesia with sevoflurane + propofol during the operation. The Mini-Mental State Examination (MMSE) was adopted to evaluate the cognitive function of the two groups at 1 hour (T1), 3 hours (T2) and 12 hours (T3) after operation, and enzyme-linked immuno-sorbent assay (ELISA) was used to determine inflammatory factors. The incidence of postoperative adverse reactions was compared between the two groups.

RESULTS

The heart rate (HR) of patients at T2 was significantly lower than that at T1 and T3, and their HR at T3 was lower than that at T1 (P<0.05). There were differences in systolic blood pressure (SBP) and diastolic blood pressure (DBP) at different time points in each group (both P<0.001). The mean artistic pressure (MAP) of patients at T2 was significantly lower than that at T1 and T3, and their MAP at T3 was lower than that at T1 (P<0.05). Additionally, oxygen saturation (SpO) of patients at T2 was also significantly lower than that at T1 and T3, and their SpO at T3 was lower than that at T1 (P<0.05). Moreover, Group B showed significantly lower levels of serum inflammatory factors than Group A at T2 and T3 (P<0.05), and also got greatly lower Observer Assessment of Sedation (OAA/S) scores than Group A (P<0.05).

CONCLUSION

Sevoflurane + propofol can effectively improve the recovery quality and cognitive function and reduce inflammation after cholecystectomy in the elderly, so it is worthy of clinical promotion.

摘要

目的

探讨七氟醚+丙泊酚在老年胆囊切除术患者中的应用价值。

方法

选取2017年2月至2020年3月在我院行胆囊切除术的121例老年患者。其中,58例患者被分配至A组,术中采用七氟醚麻醉;63例患者被分配至B组,术中采用七氟醚+丙泊酚麻醉。采用简易精神状态检查表(MMSE)在术后1小时(T1)、3小时(T2)和12小时(T3)评估两组患者的认知功能,采用酶联免疫吸附测定(ELISA)法测定炎症因子。比较两组术后不良反应的发生率。

结果

患者在T2时的心率(HR)显著低于T1和T3时,且T3时的HR低于T1时(P<0.05)。每组不同时间点的收缩压(SBP)和舒张压(DBP)均有差异(均P<0.001)。患者在T2时的平均动脉压(MAP)显著低于T1和T3时,且T3时的MAP低于T1时(P<0.05)。此外,患者在T2时的血氧饱和度(SpO)也显著低于T1和T3时,且T3时的SpO低于T1时(P<0.05)。此外,B组在T2和T3时血清炎症因子水平显著低于A组(P<0.05),且观察者镇静评分(OAA/S)也显著低于A组(P<0.05)。

结论

七氟醚+丙泊酚可有效提高老年胆囊切除术后的恢复质量和认知功能,并减轻炎症反应,因此值得临床推广。

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