全身麻醉和椎管内麻醉对老年骨科手术患者术后精神状态及认知功能的影响  

Effect of general anesthesia and spinal anesthesia on postoperative mental status and cognitive function in elderly patients with Department of orthopedics operation

作　　者：沈志耘[1] 尤杰[1] 张邓新[1] 杨定清[1] 钱红娣[1] 李国利[2] 

机构地区：[1]江南大学附属医院麻醉科,无锡214062 [2]河北北方学院附属第一医院麻醉科

出　　处：《国际精神病学杂志》2015年第6期86-90,共5页Journal Of International Psychiatry

基　　金：张家口市2013年度科学技术研究与发展计划自筹经费项目(项目编号:1321096D)

摘　　要：目的比较全身麻醉和椎管内麻醉对老年骨科手术患者术后精神状态和认知功能的影响。方法在2012年1月-2014年12月我院收治的老年骨科手术患者中随机选取采用椎管内麻醉的患者34例和采用全身麻醉的患者34例,共计68例受试者。比较两组患者的各项指标。结果观察组手术时间、睁眼时间、语言陈述时间和麻醉药用量均显著低于对照组（P〈0.05）。观察组术后1h、术后3h、术后6h的MMSE评分显著高于对照组（P〈0.05）。观察组术后1h、术后3h、术后6h的P3潜伏期显著低于对照组（P〈0.05）;而观察组术后1h、术后3h、术后6h的P3波幅显著高于对照组（P〈0.05）。结论较之全麻术,椎管内麻醉可以显著缩短老年骨伤患者手术时间、睁眼时间和语言陈述时间,减少麻醉药用量,并且对患者精神状态和认知功能的影响更低。Objective To compare the effect of general anesthesia and spinal anesthesia on postoperative mental status and cognitive function in elderly patients with the department of orthopedics operation. Methods Among the surgical patients in the Department of orthopedics in our hospital from January 2012 to December 2014.Randomly selected 34 cases of patients with spinal anesthesia,and 34 cases of patients with general anesthesia. The total of 68 subjects were tested. Comparing the indicators of two groups. Results In the observation group,operation time,eye opening time,language is stated time and anesthetic dosage were significantly lower than those in the control group（ P〈0. 05）. The 1H score of 6h,3H and MMSE in the observation group were significantly higher than those in the control group（ P〈0. 05）. The observation group after 1 h,3 h,6 h after operation after incubation period of P3 was significantly lower than the control group（ P〈0. 05）; The observation group after 1 h,3 h after operation,postoperative 6 h P3 amplitude was significantly higher than the control group（ P〈0. 05）. Conclusion compared with general anesthesia,spinal anesthesia can significantly shorten the senile patients with bone injury operation time,eye opening time and language stating the time,reduce the drug dosage,and the mental status and cognitive function of patients with the effect of lower.

关 键 词：老龄化 骨科手术 全身麻醉 椎管内麻醉 认知功能 事件相关电位 

分 类 号：R749[医药卫生—神经病学与精神病学]