【摘要】：目的探討輕度認知功能障礙(mild cognitive impairment,MCI)老年患者腰椎減壓植骨融合術(shù)七氟醚復合丙泊酚的適宜配伍劑量,以保護其認知功能。方法選擇擇期行腰椎減壓植骨融合術(shù)的患者80例,男41例,女39例,年齡65~75歲,BMI 17~26kg/m~2,ASAⅠ或Ⅱ級,術(shù)前通過蒙特利爾量表(Montreal cognitive assessment,MoCA)、簡易智力狀態(tài)量表(mini mental state examination,MMSE)、癡呆量表(dementia scale,CDR)和日常生活能力量表(daily living ability scale,ADL)評估認定為輕度認知功能障礙患者。采用隨機數(shù)字表法將患者分為四組:TCI丙泊酚2.0~2.5μg/ml組(P組)、TCI丙泊酚1.2μg/ml+七氟醚0.6 MAC組(PS1組)、TCI丙泊酚0.6μg/ml+七氟醚0.9MAC組(PS2組)和1.0~1.5MAC七氟醚組(S組)。在術(shù)前1d(T_0)、術(shù)后完全蘇醒(T_1)、3d(T_2)、7d(T_3)采用MMSE和MoCA量表評估患者認知功能,采用ELISA法測定血漿載脂蛋白J(apolipoprotein J,ApoJ)濃度。結(jié)果與T_0時比較,T_1時四組MMSE和MoCA評分明顯降低(P0.05),T_2時S組MMSE和MoCA評分明顯降低(P0.05);與T_1時比較,T_2、T_3時四組MMSE和MoCA評分明顯升高(P0.05)。T_1~T_3時S組MMSE評分明顯低于P組、PS1組和PS2組(P0.05);T_2、T_3時S組MoCA評分明顯低于P組、PS1組和PS2組(P0.05)。與T_0時比較,T_1時四組血漿ApoJ濃度明顯升高(P0.05);與T_1時比較,T_2、T_3時四組血漿ApoJ濃度明顯降低(P0.05)。T_1~T_3時S組和PS2組血漿ApoJ濃度明顯高于PS1組(P0.05)。結(jié)論 MCI老年患者行腰椎減壓植骨融合術(shù)時TCI丙泊酚1.2μg/ml復合七氟醚0.6MAC對老年患者認知功能影響較小,血漿ApoJ濃度較低。
[Abstract]:Objective to investigate the appropriate dosage of sevoflurane combined with propofol in lumbar decompression and bone graft fusion in elderly patients with mild cognitive impairment (mild cognitive impairment,MCI) in order to protect their cognitive function. Methods A total of 80 patients (41 males and 39 females, aged 65 to 75 years) undergoing lumbar decompression and bone graft fusion were enrolled in this study. The patients were divided into two groups: BMI 17 ~ 26kg 路m ~ (-1) / m ~ (2) ASA 鈪，

本文編號：2410621