摘要
目的比较全身麻醉和硬膜外麻醉对老年骨科患者术后短期认知功能的影响。方法选取2017年10月至2018年10月在我院接受骨科手术的老年患者74例,随机均分为全身麻醉组和硬膜外麻醉组,各37例。采用精神状况检测量表(MMSE)对两组患者不同时间点的认知功能进行测定。结果全身麻醉组患者在麻醉前及麻醉后6、12、24、72 h MMSE评分分别为(26.31±0.94)、(25.82±0.66)、(27.26±0.77)、(28.94±0.92)分,硬膜外麻醉组患者在麻醉前及麻醉后6、12、24、72 h MMSE评分分别为(26.66±0.82)、(25.92±0.61)、(29.31±0.84)、(29.11±0.93)分;麻醉后24 h,硬膜外麻醉组患者MMSE评分高于全身麻醉组,差异有统计学意义(P<0.05)。术后12 h内,全身麻醉组POCD发生率显著低于硬膜外麻醉组,差异具有统计学意义(P<0.05)。结论硬膜外麻醉对老年骨科患者术后认知功能障碍的影响小于全身麻醉。
Objective To compare the effects of general anesthesia and epidural anesthesia on short-term cognitive function in elderly orthopaedic patients.Methods Seventy-four elderly patients who underwent orthopaedic surgery in our hospital from October 2017 to October 2018 were randomly divided into general anesthesia group and epidural anesthesia group,37 cases each.The cognitive function of the two groups at different time points was measured by the Mental State Examination Scale(MMSE).Results The MMSE scores of patients in the general anesthesia group were(26.31±0.94),(25.82±0.66),(27.26±0.77),(28.94±0.92)points before anesthesia and 6,12,24,and 72 hours after anesthesia,respectively,the MMSE scores of patients in the epidural anesthesia group were(26.66±0.82),(25.92±0.61),(29.31±0.84),(29.11±0.93)before and at 6,12,24,and 72 hours after anesthesia;24 hours after anesthesia the MMSE score of patients in the epidural anesthesia group was higher than that in the general anesthesia group,and the difference was statistically significant(P<0.05).Within 12 hours after operation,the incidence of POCD in the general anesthesia group was significantly lower than that in the epidural anesthesia group,and the difference was statistically significant(P<0.05).Conclusion Epidural anesthesia has less effect on cognitive impairment in elderly orthopaedic patients than general anesthesia.
作者
冯天新
王月媛
FENG Tianxin;WANG Yueyuan(Department of Anesthesiology,Yingkou Central Hospital,Yingkou 115003,China)
出处
《中国医药指南》
2020年第33期124-125,共2页
Guide of China Medicine
关键词
认知功能障碍
硬膜外麻醉
全身麻醉
Postoperative cognitive dysfunction
Epidural anesthesia
General anesthesia
