摘要
目的探讨老年人非心脏手术术后认知功能障碍（POCD）发生情况及其处理。方法分析18例发生典型POCD患者资料。ASAⅠ-Ⅲ级,年龄（73.6±8.4）岁。七氟醚静-吸复合全麻手术11例,腰-硬联合麻醉7例。手术种类包括骨科、胸科、腹部和泌尿外科。术前用药均为苯巴比妥钠0.1 g、东莨菪碱0.3 mg肌注。结果POCD发生在术后24-72 h,均以夜间为重。确诊POCD后,均立即进行了积极治疗：15例予咪唑安定静注复合氟哌啶醇肌注有效;2例予咪唑安定及氟哌啶醇无效,改用哌替啶肌注后症状明显缓解;1例经以上治疗无效,改用丙泊酚持续泵注,停药16 h后恢复正常。随访至出院,全部患者均无严重的精神系统后遗症。结论POCD是老年患者术后常见的并发症,围术期必须进行积极的预防和治疗,避免出现严重的精神系统后遗症。
Objective To analyse the cognitive dysfunction early after non-cardiac surgery in elderly.Methods Eighteen elderly patients undergoing selective non-cardiac surgery were investigated.General anesthesia was used in 11 patients and combined epidural-spinal anesthesia in 7 cases.The operations involved orthopedic,thoracic,abdominal and urologic surgeries.The patients were premedicated with phynobarbital 0.1g and scopolamine 0.3mg.Results All patients suffered from typical POCD that occurred during 1 to 3 days after operation.The symptoms were more severe at night.The patients with POCD were treated effectively with intravenous injection of midozolam and muscle injection of haloperidol in 15 cases.The symptoms of POCD were attenuated by injection of pethidine in 2 cases.One case had to be given intravenous infusion of propofol continually for 16 hours.All patients were cured without psychological complications before discharge.Conclusion POCD is a common complication in the elderly and should be treated actively.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2010年第1期8-10,共3页
Journal of Clinical Anesthesiology
基金
福建省自然科学基金(2006j0191)资助课题
关键词
术后认知功能障碍
老年
Postoperative cognitive dysfunction
Geriatrics
