不同麻醉方式对老年患者术后认知功能影响的研究  

Study on the influence of different anesthesia methods on elderly patients' postoperative cognitive dysfunction

作　　者：马亚兵[1] 

机构地区：[1]甘肃省人民医院麻醉科,兰州730000

出　　处：《中国临床新医学》2014年第11期1015-1017,共3页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

摘　　要：目的：通过简易智能状态检查法（ MMSE）行神经心理学测试，探讨不同麻醉方式对老年患者术后认知功能的影响。方法选择2010-01～2011-01住院ASA分级为Ⅰ、Ⅱ级行择期手术的非心脏手术老年患者180例，随机分为硬膜外麻醉组和全身麻醉组，每组90例，对比两组患者基线情况，术前、术后3 h、9 h、3 d、5 d的MMSE评分和术后认知功能障碍（ POCO）发生率。结果两组患者基线情况比较差异均无统计学意义（ P＞0.05），术后3 h、9 h、3 d、5 d MMSE评分均有不同程度的降低。两组患者不同测量时间MMSE评分差异有统计学意义（ P＜0.05）。两组患者术后3 h、9 h POCD发生率比较差异有统计学意义（ P＜0.05），但3 d、5 d POCD发生率比较差异无统计学意义（ P＞0.05）。结论硬膜外麻醉和全身麻醉均与老年患者手术后认知功能障碍的发生有关；全身麻醉术后认知功能障碍的发生率明显高于硬膜外麻醉者。Objective To investigate the influence of different anesthesia methods on elderly patients ′post-operative cognitive dysfunction by mini-mental state examimation （ MMSE） to test neuropsychology .Methods From January 2010 to January 2011 180 elderly patients with ASAⅠ~Ⅱ,who underwent selective non-cardiac surgery, were randomized into two groups , with 90 cases in each group .One group was treated with epidural anesthesia （ epi-dural group ） and the other with general anesthesia （ general group ） .The general situation was compared between two groups.The scores of MMSE before anesthesia , at 3 hours, 9 hours,3 days,5 days after operation and rate of postop-erative cognitive dysfunction （POCD） were recorded.Results There was no significant difference in general situation between two groups （ P〉0.05 ） .The score of MMSE after anesthesia in each group were all reduced;The score of MMSE in two groups were statisticant differences （ P〈0.05 ）;The score of MMSE in different times were statisticant differences （ P〈0.05 ） .There was significant difference in rate of POCD between epidural group and general group at 3 hours and 9 hours after operation （ P〈0.05 ） .There was no significant difference in rate of POCD between epidural group and general group at 3 days and 5 days after operation （ P〉0.05 ） .Conclusion Both of epidural anesthesia and general anesthesia associated with postoperative cognitive dysfunction ,but general anesthesia technique has a pow-erful influence on cognitive function than epidural anesthesia .

关 键 词：麻醉 老年人 术后认知功能障碍 

分 类 号：R614[医药卫生—麻醉学]