摘要
目的 探讨针对老年下肢骨折患者,应用全身麻醉与椎管内麻醉对其认知功能及凝血功能的影响。方法 本次研究筛选2021年6月—2023年6月我院收治的100位老年下肢骨折患者作为研究对象,分为全身组(n=50例)和椎管组(n=50例)。全身组患者接受全身麻醉方式,椎管组患者接受椎管内麻醉方式,对比两组患者不同时间点(术前、术后1d、3d、6d)认知功能评分、不同时间点(麻醉前、麻醉诱导后、术毕即刻、术后24h、术后48h)凝血功能指标水平。结果 手术前,两组患者的MMSE评分对比差异不具备统计学意义(P>0.05);术后1d、3d、6d两组患者的MMSE评分相较于手术前均有所降低(P<0.05),但椎管组的MMSE评分高于全身组(P<0.05);全身组在术毕即刻的D-D水平高于麻醉前(P<0.05);椎管组在术毕即刻的TAT水平低于全身组(P<0.05);两组在术后24h、48h的TAT水平高于同组麻醉前(P<0.05);椎管组在麻醉诱导后、术毕即刻的FIB水平低于同组麻醉前和同时间点全身组水平(P<0.05);两组在术后24h、48h的FIB水平高于同组麻醉前(P<0.05),且椎管组在术后24h、48h的FIB水平低于全身组(P<0.05);椎管组在麻醉诱导后、术毕即刻的vWF水平低于同组麻醉前和同时间点全身组水平(P<0.05)。结论 椎管内麻醉应用于老年下肢骨折患者效果理想,可提高MMSE评分,降低认知功能问题的出现,有效改善患者血液高凝状态,相对于全身麻醉而言更适合于老年下肢骨折患者。
Objective To explore effect of general anesthesia and spinal anesthesia on cognitive function and coagulation function of elderly patients with lower limb fractures.Methods The paper chose 100 elderly patients with lower limb fractures admitted to our hospital from June 2021 to June 2023 as study subjects,and divided them into systemic group(n=50 cases)and spinal canal group(n=50 cases).Systemic group was treated with general anesthesia,while spinal canal group with intraspinal anesthesia.Cognitive function scores and coagulation function indicators were compared at different time points(preoperative,postoperative 1 day,3 days,6 days)and different time points(preoperative,induction,immediate postoperative,24 hours,and 48 hours)between two groups.Results Before surgery,there was no statistically significant difference in MMSE scores between two groups(P>0.05).on the 1st,3rd,and 6th day after surgery,MMSE scores of two groups were lower than before surgery(P<0.05),but MMSE scores of spinal canal group were higher than systemic group(P<0.05).D-D level in whole body group was higher immediately after surgery than before anesthesia (P<0.05). TAT level in spinal canal group was lower than systemic group immediately after surgery (P<0.05). TAT levels between two groups at 24 and 48 hours after surgery were higher than before anesthesia in the same group (P< 0.05). FIB levels in spinal canal group after anesthesia induction and immediately after surgery were lower than systemic group before anesthesia and at the same time point (P< 0.05). FIB levels in both groups were higher at 24 and 48 hours after surgery than before anesthesia in the same group (P<0.05), FIB levels in spinal canal group were lower than systemic group at 24 and 48 hours after surgery (P<0.05). The vWF levels in spinal canal group after anesthesia induction and immediately after surgery were lower than systemic group before anesthesia and at the same time point (P<0.05). Conclusion Spinal anesthesia can achieve ideal effect for elderly patients with lo
作者
王忠强
WANG Zhongqiang(Surgical Anesthesia Department,Wuwei City Liangzhou District Integrated Traditional Chinese and Western Medicine Hospital,Wuwei,Gansu,733000)
出处
《智慧健康》
2024年第6期129-132,140,共5页
Smart Healthcare
关键词
老年下肢骨折患者
椎管内麻醉
认知功能
凝血功能
Elderly patients with lower limb fractures
Intraspinal anesthesia
Cognitive function
Coagulation function
