摘要
目的比较两种不同麻醉方式对老年髋关节置换术患者血流动力学及术后认知功能的影响。方法将85例在我院行髋关节置换术的老年患者按随机方法分为全麻组和复合组,其中全麻组42例行全身麻醉,复合组43例采用硬膜外复合全麻,观察比较两组患者麻醉前(T1)、插管时(T2)、拔管时(T3)及拔管后30min(T4)的心率、中心静脉压变化情况以及术后认知功能情况。结果复合组患者术后12h简易精神状态量表(MMSE)评分高于全麻组,术后认知功能障碍(POCD)发生率低于全麻组,差异均有统计学意义(P<0.05);复合组患者在T2、T3时的心率及中心静脉压均低于全麻组,差异有统计学意义(P<0.05)。结论与全身麻醉相比,老年患者行髋关节置换术时实施硬膜外复合全身麻醉可有效改善患者的认知功能,且血流动力学稳定。
Objective To analyze and compare the effects of two different anesthesia methods in elderly patients undergoing hip replacement.Methods85elderly patients undergoing hip arthroplasty were randomly divided into two groups.Among them,42patients underwent general anesthesia in the general anesthesia group and43patients underwent epidural anesthesia in the general group.The heart rate,central venous pressure and postoperative cognitive function of the two groups were compared before the anesthesia(T1),at the time of intubation(T2),at the time of extubation(T3),and30min after the extubation(T4).Results The score of the Mini-Mental State Scale(MMSE)in the composite group was higher than that in the general anesthesia group.The incidence of postoperative cognitive dysfunction(POCD)was lower than that in the general anesthesia group(P<0.05);the heart rate and central venous pressure of the composite group at T2and T3were lower than those of the general anesthesia group(P<0.05).Conclusion Compared with general anesthesia,epidural combined general anesthesia in elderly patients undergoing hip arthroplasty can improve cognitive function and stabilize hemodynamics.
作者
刘彦超
LIU Yan-chao(Department of anesthesiology,Hebi people's hospital,Hebi,Henan,458030,China)
出处
《蛇志》
2018年第4期654-656,共3页
Journal of Snake
