2022 年第 3 期 第 17 卷

Supreme喉罩联合七氟烷麻醉在乳腺肿物切除术中的应用价值及对患者术后认知功能的影响

The value of Supreme laryngeal mask combined with sevoflurane anesthesia in breast tumor resection and its effect on postoperative cognitive function of patients

作者：王妍1郭丹2孙春玲1王梓3

英文作者：Wang Yan1 Guo Dan2 Sun Chunling1 Wang Zi3

单位：1辽宁省大连市中心医院第一手术室，大连116033；2辽宁省大连市中心医院甲状腺乳腺外科，大连116033；3辽宁省大连市中心医院运动医学科，大连116033

英文单位：1The First Operating Room Dalian Municipal Central Hospital Liaoning Province Dalian 116033 China; 2Department of Thyroid and Breast Surgery Dalian Municipal Central Hospital Liaoning Province Dalian 116033 China; 3Department of Sports Medicine Dalian Municipal Central Hospital Liaoning Province Dalian 116033 China

关键词：七氟烷；Supreme喉罩；乳腺肿物切除术；认知功能

英文关键词：Sevoflurane;Supremelaryngealmask;Breasttumorresection;Cognitivefunction

• 摘要：

• 目的 探讨Supreme喉罩联合七氟烷麻醉在乳腺肿物切除术中的应用价值及对患者术后认知功能的影响。方法  选取辽宁省大连市中心医院2018年3月至2020年5月收治的拟行乳腺肿物切除患者74例,应用随机数字表法分为观察组和对照组，各37例。对照组采用传统静脉注射麻醉诱导,观察组采用七氟烷麻醉诱导。比较2组围术期血流动力学指标、应激反应指标水平和认知功能。结果 与麻醉诱导时比较，喉罩置入时2组平均动脉压及心率均降低，但观察组均高于对照组，血清皮质醇、去甲肾上腺素及肾上腺素水平均升高，但观察组均低于对照组（均P＜0.05）。与术前1 d比较，术后当天2组简易智力状态检查量表（MMSE）评分均降低，但观察组高于对照组［(25.6±2.1)分比（23.4±2.1）分］，差异均有统计学意义（均P＜0.05）；术后次日和术后第3天，2组MMSE评分均高于前一时点（均P＜0.05），但2组间比较差异均无统计学意义（均P＞0.05）。结论  Supreme喉罩联合七氟烷麻醉用于乳腺肿物切除术，可有效稳定患者血流动力学指标，减少应激反应，促进术后认知功能的恢复。

• Objective   To investigate the value of Supreme laryngeal mask combined with sevoflurane anesthesia in breast tumor resection and its effect on postoperative cognitive function. Methods   Totally 74 patients undergoing breast tumor resection in Dalian Municipal Central Hospital, Liaoning Province from March 2018 to May 2020 were enrolled. They were randomly divided into observation group and control group, with 37 cases in each group. The control group was induced by conventional intravenous anesthesia, and the observation group was induced by sevoflurane anesthesia. The perioperative hemodynamic indexes, stress response indexes and cognitive function were compared between the two groups. Results  Compared with anesthesia induction, the mean arterial pressure and heart rate decreased in the two groups during laryngeal mask implantation, while those in observation group were higher than those in control group; the levels of serum cortisol, norepinephrine and epinephrine increased in the two groups during laryngeal mask implantation, while those in observation group were lower than those in control group (all P<0.05). Compared with the day before operation, the score of mini-mental state examination (MMSE) in the two groups decreased on the day after operation, but that in observation group were higher than that in control group ［(25.6±2.1) vs (23.4±2.1)］(all P<0.05); on the second day and the third day after operation, the MMSE score of the two groups were higher than that of the previous time point (all P<0.05), but there was no significant difference between the two groups (both P>0.05). Conclusions Supreme laryngeal mask combined with sevoflurane anesthesia for breast tumor resection can effectively stabilize the hemodynamic indexes of patients, alleviate the degree of stress response and promote the recovery of postoperative cognitive function.