老年骨科手术患者行全身麻醉和硬膜外麻醉对术后认知功能的影响  

The Effects of General Anesthesia and Epidural Anesthesia on Postoperative Cognitive Function in Geriatric Orthopaedic Patients

作　　者：陈小涛[1] 刘凌燕[1] 苘莲平 张秀娟[1] 

机构地区：[1]山东省文登整骨医院麻醉科,山东文登264400

出　　处：《中国医药指南》2014年第24期29-30,共2页Guide of China Medicine

摘　　要：目的观察老年骨科手术患者行全身麻醉和硬膜外麻醉对术后认知功能的影响。方法选择200例行骨科大手术的老年患者,分为观察组和对照组各100例,观察组行硬膜外麻醉,对照组行全身麻醉,使用简易精神状况检查量表(MMSE)对2组老年患者麻醉前后的不同时间点认知功能进行评估。结果两组患者麻醉前MMSE评分无统计学差异(P>0.05);对照组麻醉后6、12、24 h的MMSE评分与本组麻醉前比较存在明显差异(均P<0.01);观察组麻醉后6、12 h的MMSE评分与本组麻醉前比较存在明显差异(均P<0.01);两组患者麻醉后12、24 h的MMSE评分存在明显差异(P<0.01)。结论老年骨科手术患者行全身麻醉和硬膜外麻醉后24 h内均出现认知功能障碍,全身麻醉对术后认知功能的影响更明显。Objectives To observe the effects of of general anesthesia and epidural anesthesia on postoperative cognitive function in geriatric orthopaedic patients. Methods 200 geriatric patients for orthopaedic surgery were divided into treatment group and control group with 100 eases each group. Treatment group were given epidural anesthesia. Control group were given general anesthesia. The cognitive functions of two groups were observed using MMSE. Results There was no statistical difference of the two groups before anesthesia （P〉0.05）. In control group, the MMSE difference of 6 h, 12 h and 24 h after anesthesia compared with that before anesthesia was statistically significant （P〈0.01）, and similarly in treatment group the MMSE difference statistically significant （P〈0.01）. 12 h and 24 h after anesthesia, the MMSE difference of the two groups were statistically significant （P〈0.01）. Conclusions Geriatric orthopaedic patients suffered cognitive dysfimction within 24 h after anesthesia. The effect of general anesthesia were more obvious than epidural anesthesia.

关 键 词：老年人 骨科手术 全身麻醉 硬膜外麻醉 认知功能 

分 类 号：R683[医药卫生—骨科学]