麻醉方式对老年创伤患者术后早期认知功能的影响  

Influence of anesthesia methods on early postoperative cognitive function in elder orthopedic patients

作　　者：余斌[1] 何康梅[2] 张晓庆[1] 

机构地区：[1]同济大学附属同济医院麻醉科,上海市200065 [2]同济大学附属同济医院心身科,上海市200065

出　　处：《临床麻醉学杂志》2010年第2期110-112,共3页Journal of Clinical Anesthesiology

摘　　要：目的研究麻醉方法对老年创伤患者术后早期认知功能的影响。方法50例年龄≥65岁的股骨手术老年患者随机分成全身麻醉组(G组,28例)和单侧腰-硬联合麻醉组(E组,22例)。采用神经心理学测试技术简易智力状态检查(MMSE)术前1d及术后第1天进行评定认知功能。术后认知功能障碍(POCD)的诊断是首先计算所有患者麻醉前MMSE评分,患者以麻醉前测试值为对照,等于或超过1个标准差判断患者出现POCD。结果G组术后早期MMSE值低于E组(P<0.05);G组术后早期POCD的发生率为42.9%,明显高于E组的13.6%(P<0.05)。结论与腰-硬联合麻醉相比,全身麻醉可增加老年创伤患者术后早期第1天POCD的发生率。Objective To study the influence of anesthesia methods on early postoperative cognitive function in elder orthopedics patients. Methods Fifty patients aged more than 65 years old with fractured femur randomly received general anesthesia（group G, 28 cases） or unilateral combined spinal epidural anesthesia（group E,22 cases）. The assessment of postoperative cognitive function referred to the .scores that achieved in neuropsychological testing with mini mental state examination （MMSE） by special psychological person on the day before and the first day after surgery. It was considered to be postoperative cognitive dysfunction （POCD） when the score was ≥1 standard deviation（SD）. Results The score of MMSE was lower in group G than that in group E on the first day after surgery（P〈0. 05）. The incidence of POCD on the first day after surgery was higher in group G than that in group E（42. 9% vs. 13.6%） （P〈0. 05）. Conclusion Compared to combined spinal epidural anesthesia, more POCD takes place in the elderly underwent orthopedic surgery under general anesthesia.

关 键 词：全身麻醉 腰-硬联合麻醉 认知功能障碍 老年 

分 类 号：R614[医药卫生—麻醉学]