本文關(guān)鍵詞：神經(jīng)外科術(shù)中喚醒麻醉對患者術(shù)后神經(jīng)心理功能的影響，由筆耕文化傳播整理發(fā)布。

神經(jīng)外科術(shù)中喚醒麻醉對患者術(shù)后神經(jīng)心理功能的影響

The influence of awake craniotomy on postoperative neuropsychology

[1] [2] [3] [4]

YANG Ming-yuan, GENG Ying, WANG Gang, HAN Ru-quan（1.Department of Anesthesiology, Beijing Tiantan Hospital, Capital Medical University, Beifing 100050, China 2Department of Depres

[1]首都醫(yī)科大學附屬北京天壇醫(yī)院麻醉科,100050; [2]首都醫(yī)科大學附屬北京安定醫(yī)院抑郁癥治療中心,100088

文章摘要：目的評價神經(jīng)外科術(shù)中喚醒麻醉患者術(shù)后神經(jīng)心理功能與生活質(zhì)量。方法回顧調(diào)查81例于喚醒麻醉條件下行腦膠質(zhì)瘤切除術(shù)且隨訪資料完整患者的臨床資料，依據(jù)年齡、性別、文化程度、腫瘤位置和特征，以1：1配對選擇同期于非喚醒麻醉狀態(tài)下行腦膠質(zhì)瘤切除術(shù)患者作為對照組，通過電話隨訪了解患者術(shù)后神經(jīng)功能及心理狀況，采用36條目簡明健康調(diào)查表評價患者生活質(zhì)量。結(jié)果完成全部調(diào)查研究的喚醒麻醉組和非喚醒麻醉組患者各73例，喚醒麻醉組21例存在術(shù)后神經(jīng)功能缺損癥狀與體征，12例術(shù)后出現(xiàn)心理異常，30例存在術(shù)中知曉；而非喚醒麻醉組患者28例術(shù)后出現(xiàn)神經(jīng)功能缺損，8例存在心理異常，無一例患者存在術(shù)中知曉。喚醒麻醉組術(shù)后遠期（〉6個月）神經(jīng)功能評價僅9例仍存在神經(jīng)功能缺損癥狀與體征，少于非喚醒麻醉組的18例（P=0．038）；術(shù)后初期、中期和遠期神經(jīng)功能評價，，兩組患者生活質(zhì)量評分差異無統(tǒng)計學意義（均P〉0．05）。結(jié)論神經(jīng)外科術(shù)中喚醒麻醉腦膠質(zhì)瘤切除術(shù)是切除位于或鄰近腦功能區(qū)腫瘤的主要手術(shù)方式，可以減少術(shù)后遠期神經(jīng)功能缺損發(fā)生率，適當?shù)穆樽砉芾聿粫斐苫颊邉?chuàng)傷后心理障礙，亦不影響其術(shù)后生活質(zhì)量。

Abstr：Objective To assess the neuropsychological function and quality of life of the patients after awake craniotomy （AC）. Methods A case-control study was conducted among 81 patients who underwent awake craniotomy, and a 1-to-1 control group （matched by age, gender, degree of education, tumor location and characteristic） undergoing general anesthesia （GA） in glioma resections was assembled. The incidence of postoperative neurological deficits, psychological disorders and recurrence were investigated during telephone follow-ups, and Medical Outcomes Study Short Form 36 （SF-36） was adopted to evaluate the life quality of patients. Results Almost 73 pairs of patients fulfilled the survey of AC and GA group respectively. There were 21 patients and 28 patients with postoperative neurological deficits, and 12 patients and 8 patients with psychological disorders in AC and GA group respectively. Thirty patients of AC group had the recollection of being awake during the surgery. There were 9 patients in CA group having long-term （ 〉 6 months） neurological deficits, which was less than the number of GA group （18 patients, P = 0.038）. According to the assessment in short-term, medium-term and long-term postoperative neurological deficits, there was no significant difference in the quality-of-life scores between the two groups （P 〉 0.05, for all）. Conclusion Awake craniotomy can be the main method for removing the lesions located in or close to functional areas with lower incidence of long-term postoperative neurological deficits, and it has no significant impact on the psychological status and the quality of life postoperatively.

文章關(guān)鍵詞：

Keyword：:Anesthesia, intravenous Conscious sedation Glioma Neuropsychological tests Neurosurgical procedures Postoperative complications

課題項目：基金項目：北京市衛(wèi)生系統(tǒng)高層次技術(shù)人才資助項目（項目編號：2009-3-19）

作者信息：會員可見

  本文關(guān)鍵詞：神經(jīng)外科術(shù)中喚醒麻醉對患者術(shù)后神經(jīng)心理功能的影響，由筆耕文化傳播整理發(fā)布。