不同麻醉方式对老年创伤患者术后早期认知功能的影响  

Influence of different anesthesia methods on early cognitive function in elderly patients after trauma

作　　者：谢爱军[1] 魏秀吾[1] 上官明化[1] 郭金华[1] 罗来凤 谢鉴明 

机构地区：[1]福建省三明市第二医院麻醉科,福建三明366000

出　　处：《中国当代医药》2014年第15期97-98,101,共3页China Modern Medicine

摘　　要：目的 探讨不同麻醉方式对老年创伤患者术后早期认知功能的影响.方法 选取2010年12月～2012年12月本院就诊的老年股骨手术患者59例,随机分为观察组（29例）和对照组（30例）,观察组行单侧腰-硬联合麻醉,对照组行全身麻醉.观察两组手术前后简易精神状况检查（MMSE）评分、术后认知功能障碍（POCD）发生率及血清神经元特异性烯醇化酶（NSE）、S100B、Aβ的变化.结果 两组患者手术前后MMSE评分比较,差异有统计学意义（P＜0.05）,术后观察组MMSE评分显著高于对照组（P＜0.05）.观察组术后POCD发生率与对照组比较,差异有统计学意义（P＜0.05）.观察组术后1、4d血清NSE、S100B、Aβ均低于对照组（P＜0.05）.结论 全身麻醉对于老年创伤患者具有较严重的早期认知功能损伤,应用腰-硬联合麻醉可以极大降低老年POCD的发生率.Objective To explore the influence of different anesthesia methods on early cognitive function in elderly patients after trauma. Methods 59 cases of elderly patients with femoral operation were collected from December 2010 to December 2012 in our hospital,and were randomly divided into observation group （29 cases） and control group （30 cas- es）,combined unilateral spinal-epidural anesthesia was used to the observation group,and the general anesthesia was used to the control group.Minimum mental state examination （MMSE） score before and after operation,incidence of post- operative cognitive dysfunction （POCD） and serum NSE,S100B,Aβchanges in the two groups were observed. Results The difference was significant about the MMSE score between the two groups before and after operation （P〈0.05）.After operation,the MMSE score in the observation group was higher than that in the control group （P〈0.05）.The incidence of POCD in the observation group had significant difference compared with the control group （P〈0.05）.The serum NSE,S100B, Aβ levels in the observation group at 1 and 4 days after operation were lower than those in the control group （P〈0.05）. Conclusion General anesthesia has more serious damage of early cognitive function for elderly patients after trauma,us- ing combined spinal-epidural anesthesia can greatly reduce the incidence of senile POCD.

关 键 词：麻醉方式 老年创伤患者 术后早期认知功能 影响 

分 类 号：R614[医药卫生—麻醉学]