摘要
目的探讨异丙酚对全麻患者术后S100β蛋白的表达和认知功能的影响。方法 60例结肠癌根治术的老年患者按随机数字表分为两组,A组为异氟醚麻醉组,B组为异丙酚麻醉组。记录两组患者一般情况如苏醒时间、手术时间、输液量(含晶体和胶体)、出血量、尿量及BIS值。两组患者均分别于麻醉前、术后4 h、术后24 h、术后48 h抽取右颈内静脉血,测定血清S100β蛋白水平。两组患者均于术前、术后24 h、术后48 h采用简易精神状态检查表(MMSE)评分进行神经精神功能测试。结果两组患者苏醒和手术时间以及各时点一般情况相比差异无统计学意义;与B组各时点及麻醉前比较,A组患者术后4 h、24 h、48 h血清S100β蛋白显著增高(P<0.05);与麻醉前及B组相应时点比较,A组患者术后24 h、48 h MMSE评分显著降低(P<0.05);两组POCD的发生率差异无统计学意义(P>0.05)。结论异丙酚能减少S100β蛋白表达增高,同时能部分改善老年患者术后认知功能下降,可安全地作为老年患者全身麻醉用药。
Objective To explore the effects of propofol on early postoperative cognitive function and serum S10013 after operation in elderly patients. Methods Sixty elderly patients with colon carcinoma undergoing surgery were randomly as signed two groups, group A with isoflurane inhalation anesthesia and group B with propofol anesthesia. Recovery time, op erating time, fluid volume, blood loss, urine output and the BIS values were recorded in two groups. Blood of central ve nous were collected in times of before anesthesia, 4 h, 24 h and 48 h after operation. Serum concentration Of $10013 were measured by ELISA. The mini-mental state examinations （MMSE） were evaluated in two groups in times of before anesthe sia, 24 h and 48 h after operation. Results There was no significant difference between two groups in age, sex, body weight, recovery time, operating time, fluid volume, blood loss, urine output and the BIS values. The MMSE scores at 24 h and 48 h after operation in the group A were lower than those in the group B （P 〈 0.05）. The levels of serum S100~ at the 4 h after beginning of operation, 24 h and 48 h after operation in the group A were higher than those in the group B （P 〈 0.05）. Conclusion Propofol anesthesia shows no significant effect on postoperative cognitive function and the levels of serum $10013 in elderly patients. It can be safe general anesthesia medication for the elderly.
出处
《中国现代医生》
2012年第24期95-96,98,共3页
China Modern Doctor
