摘要
目的:探究在老年高血压患者下肢手术中应用腰-硬联合麻醉和外周神经阻滞麻醉对患者认知功能和应激反应的影响。方法:将进行下肢手术的老年高血压患者120例随机均分为两组,研究组进行外周神经阻滞麻醉,对照组进行腰-硬联合麻醉。结果:术前两组患者的血浆皮质醇、肾上腺素和内皮素水平无明显差异,差异无统计学意义(P>0.05),手术开始1 h及术后拔管时研究组患者各指标水平均明显低于对照组,差异有统计学意义(P<0.05);术后3 h、6 h研究组认知障碍发生率显著低于对照组,差异有统计学意义(P<0.05),术后1 d、3 d两组发生率无显著差异,差异无统计学意义(P>0.05)。结论:在老年高血压患者下肢手术中应用外周神经阻滞麻醉的方式有助于减少应激反应的出现,降低术后早期认知功能障碍的发生率,应用效果较为理想。
Objective To explore the effects of combined spinal-epidural anesthesia and peripheral nerve block anesthesia on cognitive function and stress response in elderly patients with hypertension undergoing lower limb surgery.Method 120 elderly patients with hypertension who underwent lower extremity surgery in our hospital were randomly divided into two groups.The study group received peripheral nerve block anesthesia and the control group received combined spinal-epidural anesthesia.Results There was no significant difference in plasma cortisol,epinephrine and endothelin levels between the two groups before operation(P>0.05).The levels of each index in the study group were significantly lower than those in the control group at the first hour of operation and after extubation,the difference was statistically significant(P<0.05).The incidence of cognitive impairment in the study group was significantly lower than that in the control group at 3 and 6 hours after operation,the difference was statistically significant(P<0.05).There was no significant difference in the incidence of cognitive impairment between the two groups at 1 and 3 days after operation(P>0.05).Conclusion The application of peripheral nerve block anesthesia in lower limb surgery of elderly patients with hypertension can help to reduce the occurrence of stress reaction and the incidence of early cognitive dysfunction after operation,and the application effect is ideal.
作者
王益群
刘怿敏
谢皇
王白云
梁娜
钟焕晖
WANG Yi-qun;LIU Yi-min;XIE Huang(Department of Anesthesiology,Affiliated Nanhua Hospital of University of South China,Hengyang 421002,China;Department of Urology Surgery,The Second Affiliated Hospital of South China University,Hengyang 421001,China)
出处
《吉林医学》
CAS
2020年第3期541-543,共3页
Jilin Medical Journal
基金
衡阳市2018年指导性项目[项目编号:S2018F9031025331]
湖南省卫生健康委2019年度科研计划课题项目[项目编号:B2019206]
关键词
老年高血压
下肢手术
腰-硬联合麻醉
外周神经阻滞
应激反应
认知功能
Elderly hypertension
Lower extremity surgery
Combined spinal-epidural anesthesia
Peripheral nerve block
Stress response
Cognitive function
