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目的:探讨不同麻醉选择对老年肺肿瘤术后患者早期认知功能的影响。方法:分析我院2011年3月至2013年3月老年肺肿瘤患者,分别有62例用全凭静脉麻醉和61例用静吸复合麻醉的麻醉方法,记录手术时间和麻醉时间,用MMSE量表进行认知功能评分,分别评定手术前1天和手术后出麻醉室时及1、3、5天患者的认知功能,并判断患者的POCD。结果:两组患者在手术时间和麻醉时间方面无统计学差异。与术前1天比较,全凭静脉麻醉组、静吸复合麻醉组出麻醉恢复室时、术后1 d时MMSE评分降低(P<0.05);与术前1 d比较,两组在术后3天和7天时MMSE评分恢复正常(P>0.05),两组患者之间的MMSE认知功能评分在术前、术后均无统计学差异(P>0.05),出麻醉恢复室时,全凭静脉麻醉组发生POCD24例(39.34%),全凭静脉麻醉组发生25例(40.32%),两组发生率比较无统计学差异(P>0.05);术后1天、3天、7天两组分别POCD的发生率比较均无统计学意义(P>0.05)。结论:老年患者用全凭静脉麻醉、静吸复合麻醉不同麻醉方法对老年患者术后早期发生认知功能障碍的影响无统计学差异。
Objective: To investigate the effect of different anesthesia options on early cognitive function in elderly patients with lung cancer. Methods: The patients with lung cancer in our hospital from March 2011 to March 2013 were analyzed. Totally 62 cases were treated with total intravenous anesthesia and 61 cases with static suction combined anesthesia. The operation time and anesthesia time were recorded. The cognitive function was scored and the cognitive function of patients at 1 day before operation and after operation at anesthesia and at 1, 3 and 5 days were assessed respectively. The POCD of patients was also evaluated. Results: There was no significant difference between the two groups in terms of operation time and anesthesia time. Compared with the preoperative day 1, the MMSE score of the total intravenous anesthesia group and the static inhalation combined anesthesia group anesthesia recovery group decreased 1 d after operation (P <0.05); compared with the preoperative 1 d, The MMSE score returned to normal at 3 days and 7 days (P> 0.05). There was no significant difference in MMSE scores between the two groups before and after surgery (P> 0.05) There were 24 cases of POCD (39.34%) in intravenous anesthesia group and 25 cases (40.32%) in intravenous anesthesia group. There was no significant difference between the two groups (P> 0.05); 1 day, 3 days and 7 days There was no significant difference in the incidence of POCD between the two groups (P> 0.05). Conclusion: Elderly patients with total intravenous anesthesia, intravenous anesthesia anesthesia anesthesia in elderly patients with early postoperative cognitive impairment had no significant difference.