《中国康复理论与实践》

《中国康复理论与实践》 ›› 2013, Vol. 19 ›› Issue (07): 671-673.

• 论文 • 上一篇    下一篇

老年患者全麻苏醒期脑电双频谱指数对术后认知功能的影响

甄宇，张滨，王敏，董鹏，田鸣   

  1. 首都医科大学附属北京友谊医院麻醉科，北京市100050。
  • 收稿日期:2013-01-09 修回日期:2013-02-04 出版日期:2013-07-25 发布日期:2013-07-25
  • 通讯作者: 田鸣

Effects of Awake Bispectral Index on Postoperative Cognitive Function in the Elderly

ZHEN Yu, ZHANG Bin, WANG Min, et al.   

  1. Department of Anesthesia, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
  • Received:2013-01-09 Revised:2013-02-04 Published:2013-07-25 Online:2013-07-25

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摘要： 目的观察苏醒期脑电双频谱指数(BISawake)与术后认知功能的关系。方法100 例60~75 岁、ASA Ⅰ~Ⅱ级、行下腹部手术的老年患者，采用全静脉麻醉(丙泊酚、瑞芬太尼和罗库溴氨)。术中BIS 控制在40~60。手术前后采用国际术后认知功能障碍研究协作组(ISPOCD)推荐的系列测试量表进行认知功能评估。结果8 例患者由于不愿合作或出现严重并发症退出。BISawake与睁眼时间和拔管时间呈负相关。68 例患者BISawake大于65(A组)，24 例BISawake小于65(B 组)，B 组词语记忆和词语延迟记忆两项评分术前术后差值与A组相比增大(P<0.05)。结论BISawake降低的患者可能预示着术后词语相关认知功能减退。

关键词: 脑电双频谱指数, 术后认知功能障碍, 苏醒期, 老年人

Abstract: Objective To observe the relationship of awake bispectral index (BISawake) and the postoperative cognitive dysfunction (POCD). Methods 100 patients aged 60~75 years with ASA status Ⅰ~Ⅱ, underwent elective lower abdominal surgery with intravenous anesthesia (propofol, remifentanyl and rocuronium). The BIS was adjusted in 40~60 during the surgery. Their cognitive function was assessed with the neuropsychological test battery commended by International study of postoperative cognitive dysfunction (ISPOCD). Results 8 patients withdrew for unwilling or serious complications. The BISawake was more than 65 in 68 patients (group A), and less than 65 in 24 patients (group B). The difference of the verbal learning immediate and delayed of Hopkins Verbal Learning Test-Revised was more in the group B than in the group A. Conclusion Lower BISawake may be associated with the decline of postoperative cognitive function.

Key words: bispectral index, postoperative cognitive dysfunction, awake, elderly