【摘要】

目的：探究老年手术患者接受静脉全麻、吸入全麻对术后认知功能障碍（POCD）与复苏质量造成的影响。
方法：2017年5月-2019年5月期间老年手术患者88例，随机分为对照组（七氟醚全凭吸入麻醉）与观察组（异丙酚全凭静脉维持麻醉）各44例，对比两组麻醉效果。
结果：（1）观察组拔管时间、苏醒时间均短于对照组，躁动发生率低于对照组，P均＜0.05。（2）两组T0、T1、T2、T3血浆白介素-6（IL-6）水平对比，P＞0.05；两组T0、T3时刻S100β水平对比，P＞0.05；观察组T1、T2时期100β水平低于对照组，P＜0.05。（3）两组同期简明精神状态检查量表（MMSE）评分对比，P均＞0.5；两组POCD发生率对比，P＞0.05；（4）观察组低血压、恶心呕吐发生率低于对照组，P＜0.05；观察组心动过缓发生率高于对照组，P＜0.05；两组镇痛不全发生率对比，P＞0.05。
结论：静脉麻醉缩短苏醒时间与拔管时间，更少造成术中低血压、拔管期躁动，有利于术后苏醒，可减少术后恶心呕吐发生，可能是老年手术患者的首选维持麻醉方案，但是静脉麻醉更容易造成心动过缓，慢性心律失常患者需谨慎使用。

【Abstract】

Objective: To explore the effects of intravenous and inhalation general anesthesia on postoperative cognitive impairment (POCD) and quality of resuscitation in elderly patients undergoing surgery.
Methods: 88 elderly patients undergoing surgery from May 2017 to May 2019 were randomly divided into control group (sevoflurane anesthesia by inhalation) and observation group (propofol anesthesia by intravenous maintenance) with 44 cases in each group. The anesthetic effect of the two groups was compared.
Results: (1) The extubation time and recovery time of the observation group were shorter than those of the control group, and the incidence of restlessness was lower than that of the control group, all P < 0.05. (2) The levels of plasma interleukin-6 (IL-6) in T0, T1, T2 and T3 of the two groups were compared, P > 0.05; the levels of S100 beta at T0 and T3 of the two groups were compared, P > 0.05; the levels of 100 beta at T1 and T2 of the observation group were lower than those of the control group, P < 0.05. (3) Simple Mental State Examination Scale (MMSE) score of the two groups at the same time, P > 0.5; POCD incidence of the two groups, P > 0.05; (4) The incidence of hypotension, nausea and vomiting in the observation group was lower than that in the control group, P < 0.05; the incidence of bradycardia in the observation group was higher than that in the control group, P < 0.05; the incidence of analgesia incompleteness in the two groups was higher, P > 0.05. CONCLUSION: Intravenous anesthesia can shorten the recovery time and extubation time, reduce intraoperative hypotension and restlessness during extubation, and is conducive to postoperative recovery. It can reduce the occurrence of postoperative nausea and vomiting. It may be the first choice of maintenance anesthesia for elderly patients undergoing surgery, but intravenous anesthesia is more likely to cause bradycardia, and patients with chronic arrhythmia need to use cautiously.