2018 年第 1 期 第 13 卷

丙泊酚静脉麻醉对老年良性前列腺增生患者术后简易智力状态检查量表评分及血清神经元特异性烯醇化酶和神经生长因子水平变化的影响

作者：青艾伶

英文作者：

单位：610000成都，四川大学华西第四医院麻醉科华西公共卫生学院

英文单位：

关键词：良性前列腺增生；丙泊酚；简易智力状态检查量表评分；神经元特异性烯醇化酶；神经生长因子

英文关键词：

• 摘要：

• 【摘要】目的    分析丙泊酚静脉麻醉对老年良性前列腺增生患者术后简易智力状态检查量表（MMSE）评分及血清神经元特异性烯醇化酶（NSE）和神经生长因子（NGF）水平变化的影响。方法    选取2014年5月至2017年6月于四川大学华西第四医院行前列腺电切术治疗的老年良性前列腺增生患者98例，采用抽签法分为对照组和观察组，各49例。对照组予以七氟烷吸入维持麻醉，观察组予以丙泊酚静脉维持麻醉。对比2组麻醉情况、不良反应发生率及术后认知功能障碍发生率，并比较2组术前与术后6 h、1 d、3 d的MMSE评分及血清NSE、NGF水平。结果    2组麻醉时间、术后自主呼吸恢复时间及清醒时间比较差异均无统计学意义（均P＞0.05）。2组术前及术后3 d的MMSE评分差异无统计学意义（P＞0.05），术后6 h、1 d的MMSE评分均较术前降低，但观察组降低幅度小于对照组［（24.5±1.5）分比（22.7±1.7）分、（26.1±1.8）分比（24.4±1.9）分］（P＜0.05）；2组术后6 h、1 d的血清NSE均较术前升高，但观察组升高幅度小于对照组（P＜0.05）；2组术后6 h、1 d的血清NGF水平均较术前降低，但观察组降低幅度小于对照组，差异有统计学意义（P＜0.05）；观察组不良反应发生率与对照组差异无统计学意义［6.1%(3/49)比8.2%（4/49）］（P＞0.05）；观察组术后认知功能障碍发生率低于对照组［16.3%（8/49）比34.7%（17/49）］（P＜0.05）。结论    对行前列腺电切术治疗的老年良性前列腺增生患者予以丙泊酚静脉维持麻醉麻醉效果确切，且对患者认知功能与血清NSE、NGF水平影响较小，不良反应较少。

• Effect of propofol intravenous anesthesia on postoperative Mini-Mental State Examination score, serum neuron specific enolase and nerve growth factor levels in elderly patients with benign prostatic hyperplasia

  Qing Ailing

  Department of Anesthesiology, No.4 West China Teaching Hospital, West China School of Public Health, Sichuan University, Chengdu 610000, China, Email: mail2qing@163.com

  【Abstract】Objective     To investigate the effect of propofol intravenous anesthesia on postoperative Mini-Mental State Examination(MMSE) score, serum neuron specific enolase(NSE) and nerve growth factor(NGF) levels in elderly patients with benign prostatic hyperplasia(BPH). Methods    Totally 98 patients with BPH undergoing electro-prostatectomy from May 2014 to June 2017 in No.4 West China Teaching Hospital, Sichuan University were randomly divided into control group and observation group, with 49 cases in each group. The control group had sevoflurane inhalation anesthesia; the observation group had propofol intravenous anesthesia. Anesthesia condition, occurrences of adverse reactions and cognitive impairment were recorded. The MMSE score, serum levels of NSE and NGF were recorded before operation and 6 h, 1 d, 3 d after operation. Results    Anesthesia time, postoperative spontaneous respiration recovery time and awakening time had no significant differences between groups(P>0.05). Preoperative and postoperative 3 d MMSE scores had no significant differences between groups(P>0.05). Postoperative 6 h and 1 d MMSE scores were significantly lower than the preoperative ones in both groups; postoperative 6 h and 1 d MMSE scores in observation group were higher than those in control group［（24.5±1.5）points vs（22.7±1.7）points, （26.1±1.8）points vs（24.4±1.9）points］（P＜0.05）. Postoperative 6 h and 1 d serum NSE levels were significantly higher than the preoperative ones in both groups; postoperative 6 h and 1 d serum NSE levels in observation group were lower than those in control group（P＜0.05）. Postoperative 6 h and 1 d serum NGF levels were significantly lower than the preoperative ones in both groups; postoperative 6 h and 1 d serum NGF levels in observation group were higher than those in control group（P＜0.05）. There was no significant difference of adverse reaction rate between groups［6.1%(3/49) vs 8.2%（4/49）］（P＞0.05）. Postoperative cognitive impairment rate in observation group was significantly lower than that in control group［16.3%（8/49） vs 34.7%（17/49）］（P＜0.05）. Conclusion    Intravenous administration of propofol is effective for BPH patients with electro-prostatectomy without side effects on cognitive function and serum levels of NSE and NGF.

  【Key words】Benign prostatic hyperplasia;Propofol;Mini-Mental State Examination score;Neuron specific enolase;Nerve growth factor