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背景:近年来,无痛内镜检查后24 h内不能驾车的规定受到越来越多的质疑。目的:探讨无痛内镜检查对术后早期认知功能的影响。方法:随机选取至少接受9年义务教育、进行无痛上消化道内镜检查(EGD)的患者100例,100例进行普通EGD检查的患者作为对照组。丙泊酚麻醉或内镜操作前以数字连接试验-A(NCT-A)、数字划消试验和数字符号试验(DST)进行认知功能测试,达到离院标准时重复上述测试,如结果劣于检查前,静息30 min后进行第三次测试,直至结果恢复至或优于检查前水平。结果:200例患者均完成前两次测试,124例完成第三次测试。达到离院标准时,无痛EGD组数字划消试验结果显著劣于检查前(P=0.000);进一步按年龄段分组,青年组数字划消试验结果显著劣于检查前(P=0.000),老年组NCT-A结果显著劣于检查前(P=0.025);普通EGD对照组3项测试结果均不劣于检查前。完成第三次测试者各项测试结果均恢复至或优于检查前水平。结论:丙泊酚无痛内镜检查可影响患者的术后早期认知功能,但此种影响可通过适当延长离院时间得以恢复。患者的最适离院时间以及多久后方可驾车有待进一步研究确定。
Background: In recent years, the requirement of no driving within 24 h after painless endoscopy has been questioned more and more. Objective: To investigate the effect of painless endoscopy on early postoperative cognitive function. Methods: 100 patients with at least 9 years of compulsory education, painless upper gastrointestinal endoscopy (EGD), and 100 patients with normal EGD were randomly selected as the control group. Before anesthesia or propofol anesthesia or endoscopic operation with digital connection test-A (NCT-A), digital cancellation test and digital sign test (DST) cognitive function test, to reach the hospital standard repeats the above test if the result is worse than Before the test, the third test is performed 30 minutes after resting until the result is restored to or better than the pre-test level. Results: All 200 patients completed the first two tests and 124 completed the third test. When the standard of leaving hospital was reached, the result of digital cancellation test in painless EGD group was significantly worse than that of before examination (P = 0.000); further by age group, the result of digital cancellation test in youth group was significantly worse than that before examination (P = 0.000) Group NCT-A results were significantly worse than before the test (P = 0.025); common EGD control group 3 test results were not worse than before the test. The third test to complete the test results were restored to or better than the pre-test level. Conclusion: Propofol painless endoscopy can affect early postoperative cognitive function in patients, but this effect can be resumed by appropriately prolonging the time of leaving hospital. The patient’s optimal time to leave and how long to drive can be determined by further research.