摘要
目的:研究不同麻醉方法对高龄甲状腺瘤患者早期术后认知功能的影响。方法:随机选择60例年龄≥65岁的甲状腺瘤手术老年患者,其中男38例,女22例,分为全身麻醉组(A组,30例)和颈丛阻滞组(B组,30例),由同一试验者采用神经心理学测试技术简易智力状态检查(MMSE)两组患者术前1d、术后12h和术后24 h的认知功能。排除有精神病史或长期服用影响神经系统功能药物的患者。结果:二组术后12h的MMSE值低于术前(P<0.05),组间比较差异无统计学意义(P>0.05);A组术后12 h和24 h POCD的发生率为分别16.7%和3.3%,B组的术后12 h和24 h POCD的发生率为分别10.0%和3.3%(P>0.05)。结论:与颈丛阻滞相比,全身麻醉不会增加高龄甲状腺瘤患者早期术后认知功能障碍的发生率。
Objective： To study the influence of different anesthesia methods （plexus cervicalis block and general anesthesia） on early postoperative cognitive function in elderly patients who suffer from thyroid disease. Methods： Sixty patients more than 65 years old with thyroid disease were randomly given general anesthesia （ Group A, 30 cases ） and plexus cerviealis block （ Group B, 30 cases ）. The assessment of postoperative cognitive function refers to the scores achieved in the neuropsychological testing using the mini mental state examination （ MMSE ） by the same psychiatrist on the day before the operation and the first 12 and 24 h after the surgery. Patients with psychosis or neuropathy were excluded, as well as patients who take medicines that affect nervous system function long-term were also excluded. The aggregate MMSE score is 30. The standard deviation of the patient MMSE before the operation was calculated and compared with those of the first 12 and 24 h after the surgery. Results： The MMSE scores were lower in Groups A and B within the first 12 h after surgery than that before the operation （ P 〈 0.05 ）. The incidence of POCD in Group A within the first 12 and 24 h after surgery （ 16.7% and 3.3% ） was not statistically different from that in Group B （ 10.0% and 3.3%; P 〉 0.05 ）. Conclusion： There is a higher incidence of early POCD after thyroid surgery, especially among patients more than 65 years old. Compared with the patients who underwent the plexus cervicalis block, the incidence of POCD among the elderly who underwent thyroid surgery under general anesthesia was lower.
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2011年第12期731-733,共3页
Chinese Journal of Clinical Oncology
关键词
全身麻醉
颈丛阻滞
高龄
甲状腺
术后认知功能障碍
General anesthesia
Plexus cervicalis block
Elder patients
Thyroid gland
Postoperative cognitive dysfunction
