摘要目的 本研究评估老年患者在日间手术后24 h内POCD发生,及血清神经损伤标志物-S-100蛋白和神经特异性烯醇化酶变化.方法 老年患者30例,随机分为异丙酚静脉麻醉组、七氟醚吸入麻醉组;观察在日间手术后24 h内POCD的发生,及血清神经损伤标志物S-100蛋白和神经特异性烯醇化酶变化.结果 POCD发生较对照组高,P=0.03.S-100蛋白和神经特异性烯醇化酶与对照组及术前没有显著变化.结论 老年患者在日间手术后24 h内POCD发生,较以往报道的大手术后7 d内发生高;S-100蛋白和神经特异性烯醇化酶水平无变化.

abstractsObjective Postoperative cognitive dysfunction (POCD) is evident in 26% of elderly patients seven days after major non-cardiac surgery.Despite the growing popularity of day surgery,the influence of anesthetic techniques on next day POCD has not been investigated.Therefore,we evaluated the incidence of POCD and changes in serum markers of neuronal damage (S-100β protein and Neuron-Specific Enolase),24 hr after single-agent propofol or sevoflurane anesthesia in elderly patients undergoing minor surgery.Methods Patients (n=30,mean age 73,range 65-86 yr) coming for cystoscopy or hysteroscopy,were randomized,in an observer-blind design,to receive either single-agent propofol or sevoflurane anesthesia.Changes in S-10013 protein and Neuron-Specific Enolase levels were also documented.Results POCD Was present in 7/15 patients who received propofol and 7/15 patients who received sevoflurane,compared with 1/15 control patients,P=0.03.S100β protein and Neuron-Specific Enolase levels were not significantly different in anesthetized patients postoperatively compared with preoperative values.