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目的;探讨评价麻醉深度监测仪监测下不同麻醉方式对老年结直肠癌患者腹腔镜手术快速康复的影响。方法:选取2013年6月至2015年6月江门市中心医院结直肠癌老年患者共60例,均拟行麻醉下手术。分别采用不同麻醉方式:七氟醚加瑞芬太尼S组(20例),丙泊酚加瑞芬太尼P组(20例),丙泊酚加七氟醚加瑞芬太尼平衡麻醉B组(20例),手术前及复苏拨管后30 min行血气分析对比血糖、血乳酸,记录麻醉深度监测仪监测过程中动脉血压、体温、心率、血氧饱和度、脑电双频指数(BIS),于术前1 d、术后第1、2、7 d,用精神状态量表(MMSE)评分进行评价。结果:患者术后第1、2、7 d与手术前比较,MMSE评分明显下降(P<0.05),各组间比较,B组明显高于S组、P组,差异有统计学意义(P<0.05),而S组与P组比较,差异无统计学意义(P>0.05)。与手术前比较,三种麻醉方式的心率、动脉血压、血氧饱和度、体温值均降低,BIS、血糖、全血乳酸均升高,差异具有统计学意义(P<0.05);S组、P组的心率、BIS、动脉血压、血氧饱和度、体温值均低于B组,组间比较,差异具有统计学意义(P<0.05);血糖、全血乳酸与B组比较,差异无统计学意义(P>0.05),S组与P组各项指标比较,差异无统计学意义(P>0.05)。结论:老年结直肠癌患者腹腔镜手术中采取丙泊酚加瑞芬太尼加七氟醚平衡麻醉,有利于维持人体循环稳定,有利于术后快速康复。
Objective To evaluate the effects of different modes of anesthesia on the rapid rehabilitation of elderly patients with colorectal cancer undergoing laparoscopic surgery under the surveillance of the depth of anesthesia monitor. Methods: A total of 60 elderly patients with colorectal cancer in Jiangmen Central Hospital from June 2013 to June 2015 were selected and underwent anesthesia. Different anesthesia was used: sevoflurane plus remifentanil S group (20 cases), propofol plus remifentanil group P (20 cases), propofol plus sevoflurane plus remifentanil balanced anesthesia Group B (n = 20), blood gas analysis was performed 30 min before and after dialysis resuscitation to compare blood glucose, blood lactic acid, arterial blood pressure, body temperature, heart rate, oxygen saturation, (BIS) were evaluated on the first day before operation and on the 1st, 2nd and 7th day after operation, using MMSE score. Results: The scores of MMSE on the 1st, 2nd, 7th day after operation were significantly lower than those before operation (P <0.05). The B group was significantly higher than the S group and the P group <0.05), but there was no significant difference between S group and P group (P> 0.05). Compared with those before operation, the heart rate, arterial blood pressure, oxygen saturation and body temperature decreased, BIS, blood glucose and whole blood lactate increased with the three anesthesia methods, the difference was statistically significant (P <0.05) The heart rate, BIS, arterial blood pressure, oxygen saturation and body temperature in group P were lower than those in group B (P <0.05). There was no significant difference in blood glucose, whole blood lactate between group B and group B Statistical significance (P> 0.05), S group and P group of the indicators, the difference was not statistically significant (P> 0.05). Conclusion: Propofol plus remifentanil plus sevoflurane balanced anesthesia in elderly patients with colorectal cancer during laparoscopic surgery is conducive to maintaining the circulatory stability of the human body and is conducive to rapid recovery after surgery.