不同麻醉深度对老年患者术后认知功能障碍发生的影响

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目的:探讨不同麻醉深度对老年胃、肠道恶性肿瘤患者术后认知功能障碍(POCD)影响。方法:收集本科室2013年1月至2014年8月入院进行胃肠道恶性肿瘤手术的老年患者86例,ASA 分级为一级或二级,术前24小时简易精神状态量表(MMSE)计分不小于24分的患者。利用 BIS 检测患者麻醉深度,将 BIS 40~65的分为第一组,BIS 30~40分为第二组,术后24h,48h,72h 分别用 MMSE 标准表评定患者是否有 POCD。同时比较两组老年患者基本情况及手术中补液量,出血量,输血量及低血压发生率。结果:老年患者全身麻醉后行胃、肠道恶性肿瘤手术后,老年患者会因为麻醉深度的差异而产生不同程度的认知功能障碍,BIS 值40~65时的 POCD 发生率显著高于 BIS 值30~40(P <0.05),但是两组患者的基本情况及手术中补液量,出血量,输血量及低血压发生率无显著差异。结论:不同麻醉深度对老年胃、肠道恶性肿瘤患者术后 POCD 发生率有显著影响。
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