摘要
目的观察全身麻醉(全麻)联合硬膜外阻滞对老年股骨骨折患者术后早期认知功能障碍(POCD)的影响。方法行股骨骨折手术患者90例,年龄65~78岁,随机分为两组,每组45例。A组硬膜外阻滞后实施全麻;C组单用全麻。两组术后均行静脉患者自控镇痛。于术前(T0)、术后6h(T1)、12h(T2)和24h(T3)采集颈内静脉血样,测定血清S-100β蛋白、IL-6浓度,记录患者T0、T1、T2和T3时的简易智力状态检查量表(MMSE)评分,计算POCD发生率。结果T1、T2和T3时,A组的血清S-100β蛋白和IL-6浓度均低于C组(P<0.05),MMSE评分均高于C组(P<0.05)。A组POCD发生率低于C组(11.6%vs.29.5%)(P<0.05)。结论与全麻比较,全麻联合硬膜外阻滞可以减少老年股骨骨折患者POCD的发生。
Objective To observe the effect of general anesthesia combined with epidural block on early postoperative cognitive dysfunction(POCD)in elderly patients underwent femoral fracture surgery.Methods Ninety patients aged 65-78 years old undergoing femoral fracture surgery were randomly divided into two groups with 45 cases each.General anesthesia combined with epidural block was used in group A and general anesthesia alone was used in group C.Intravenous patient-controlled analgesia was used after operation in two groups.Blood samples from internal jugular vein were collected for the detection of serum S-100β protein and IL-6 before operation(T0),at 6 hours(T1),12 hours(T2)and 24 hours after operation(T3).The mini-mental state examination(MMSE)scores were recorded at T0,T1,T2 and T3 and the incidence of POCD was calculated.Results At T1,T2 and T3,serum levels of S-100β protein and IL-6 at T1-T3 were lower and MMSE scores were higher significantly in group A than those in group C(P<0.05).The incidence of POCD in group A was significantly lower than that in group C(11.6%vs.29.5%)(P<0.05).Conclusion Compared to general anesthesia,general anesthesia combined with epidural block can reduce the incidence of early POCD in elderly patients undergoing femoral fracture surgery.
作者
包文敏
BAO Wenmin(Department of Anesthesiology,Hospital of Changxing County,Changxing 313100,CHINA)
出处
《江苏医药》
CAS
2019年第10期1055-1057,共3页
Jiangsu Medical Journal
关键词
术后认知功能障碍
硬膜外阻滞
全身麻醉
股骨骨折
老年
Postoperative cognitive dysfunction
Epidural block
General anesthesia
Femoral fracture
Geriatrics
