本文選題：帕金森病 + 蘇醒時(shí)間�。� 參考：《臨床麻醉學(xué)雜志》2015年05期

【摘要】：目的觀察帕金森病患者行下腹或下肢手術(shù)全麻蘇醒蘇醒質(zhì)量及認(rèn)知功能的變化。方法選擇擇期在全身麻醉下行下腹或下肢手術(shù)的帕金森病患者26例(PD組)和在全身麻醉下行下腹或下肢手術(shù)的無(wú)帕金森病病史患者26例(NP組),于術(shù)前1d采用簡(jiǎn)易精神狀態(tài)量表(MMSE)對(duì)認(rèn)知功能評(píng)分。兩組均使用咪達(dá)唑侖、芬太尼、順阿曲庫(kù)銨、丙泊酚行麻醉誘導(dǎo),術(shù)中丙泊酚以5mg·kg-1·h-1和瑞芬太尼6μg·kg-1·h-1為起始輸注速度,并根據(jù)BIS和MAP調(diào)節(jié)兩種麻醉藥物輸注速度維持適宜麻醉深度,記錄低血壓發(fā)生次數(shù)和升壓藥物用量。術(shù)畢停止丙泊酚和瑞芬太尼的輸注,觀察并記錄首次睜眼時(shí)間、拔管時(shí)間、達(dá)OAA/S評(píng)分5分時(shí)所需時(shí)間及術(shù)后24h的MMSE評(píng)分。結(jié)果 NP組術(shù)中瑞芬太尼和丙泊酚用量明顯多于PD組(P0.05),NP組血壓下降次數(shù)和去氧腎上腺素用量明顯少于PD組(P0.05);NP組的首次睜眼時(shí)間、拔管時(shí)間、達(dá)OAA/S評(píng)分5分時(shí)所需時(shí)間明顯短于PD組(P0.05);NP組術(shù)后24h的MMSE評(píng)分明顯高于PD組(P0.05)。多元線性回歸分析顯示:帕金森病(β=0.513,t=3.350,P0.05)是影響達(dá)到OAA/S 5分所需時(shí)間的顯著預(yù)測(cè)變量(R2=0.256,回歸模型F=3.163,P0.05)。其余因素均為不顯著的預(yù)測(cè)變量。帕金森病(β=0.468,t=3.203,P0.05)也是影響術(shù)后24h MMSE評(píng)分的顯著預(yù)測(cè)變量(R2=0.325,回歸模型F=4.430,P0.05)。其余因素均為不顯著的預(yù)測(cè)變量。結(jié)論帕金森病患者較非帕金森病患者的全身麻醉蘇醒時(shí)間延長(zhǎng),術(shù)后24h認(rèn)知功能顯著低于非帕金森病患者。
[Abstract]:Objective to observe the changes of recovery quality and cognitive function in patients with Parkinson's disease undergoing lower abdominal or lower limb surgery under general anesthesia. Methods A total of 26 patients with Parkinson's disease undergoing lower abdominal or lower limb surgery under general anesthesia and 26 patients with no history of Parkinson's disease undergoing lower abdominal or lower extremity surgery under general anesthesia were enrolled in this study. Mental state scale (MMSE) was used to evaluate cognitive function. Midazolam, fentanyl, cisatracurium and propofol were used to induce anesthesia. The initial infusion rate of propofol was 5mg kg-1 h-1 and remifentanil 6 渭 g kg-1 h-1, and the appropriate depth of anesthesia was maintained according to BIS and map. The incidence of hypotension and the dosage of antihypertensive drugs were recorded. The infusion of propofol and remifentanil was stopped at the end of the operation. The first time of eye opening, the time of extubation, the time required to reach the OAA / S score of 5 and the MMSE score 24 hours after operation were observed and recorded. Results the dosage of remifentanil and propofol in NP group was significantly higher than that in PD group (P 0.05). The time required to reach OAA / S score at 5 was significantly shorter than that in PD group (P 0.05 / NP group) 24 h after operation, and was significantly higher than that in PD group (P 0.05). Multivariate linear regression analysis showed that Parkinson's disease (尾 = 0.513) was a significant predictor of the time required to reach OAA / S score (P 0.05), and the regression model was F _ (3.163) (P _ (0.05), which was a significant predictor of the time required to reach OAA / S _ (5). The other factors were not significant predictive variables. Parkinson's disease (P = 0.468) was also a significant predictor of MMSE score at 24 hours postoperatively (P < 0.05), and the regression model was F _ (4.430) (P _ (0.05). The other factors were not significant predictive variables. Conclusion the recovery time of general anesthesia in patients with Parkinson's disease is longer than that in patients with non Parkinson's disease, and the cognitive function at 24 hours after operation is significantly lower than that in patients with non Parkinson's disease.
【作者單位】： 河北醫(yī)科大學(xué)附屬哈勵(lì)遜國(guó)際和平醫(yī)院麻醉科;河北醫(yī)科大學(xué)附屬哈勵(lì)遜國(guó)際和平醫(yī)院神經(jīng)內(nèi)科;
【分類號(hào)】：R614

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本文編號(hào)：2005166