不同全麻方法对学龄期儿童股骨干骨折内固定手术后近期认知功能的影响  

Influence of cognition function in children after femoral fracture fixation surgery under two methods of general anesthesia

作　　者：于生喜[1] 管小红[1] 刘宏 

机构地区：[1]大连市儿童医院,辽宁大连116011 [2]大连市第七人民医院,辽宁大连116023

出　　处：《四川精神卫生》2017年第2期136-139,共4页Sichuan Mental Health

摘　　要：目的探讨全麻术对学龄期股骨干骨折内固定手术患儿近期认知功能的影响。方法以2015年1月-12月在大连市儿童医院接受股骨干骨折内固定的手术患儿为患者组,符合入组标准共60例,按随机数字表法分为全凭静脉麻醉组(T组)和吸入麻醉组(I组),每组各30例。采用抽签法随机抽取大连市西岗区两所小学6~12岁健康学龄期儿童30例作为对照组。分别于术前和术后第7天采用中国修订韦氏儿童智力量表(C-WISC)评定患者组与对照组的认知功能。结果共84例儿童完成研究,其中T组、I组、对照组分别为27例、29例、28例。术前三组的C-WISC各条目评分差异均无统计学意义(P均>0.05);术后第7天,I组联想学习、数字符号评分低于治疗前和对照组,差异均有统计学意义(P均<0.05);T组联想学习、数字广度和数字符号评分低于治疗前和对照组,差异均有统计学意义(P均<0.05);两患者组的各条目评分差异均无统计意义(P均>0.05)。结论全麻可能会导致学龄期患者近期认知功能受损,不同的全麻方法对学龄期患者认知功能的损害程度相当。Objective To investigate the influence of cognition function in children after femoral fracture fixation surgery under two kinds of general intravenous anesthesia.Methods A total of 60children who received operation of femoral fracture internal fixation in Dalian Childrens Hospital from January to December 2015 were selected as patient group.All patients were divided into total intravenous anesthesia group （T group） and inhalation anesthetic group （I group） according to random number table,each group of 30cases.30healthy school-age children from two elementary schools of Xigang District,Dalian City were selected as control group.Cognitive function was assessed by Chinese Wechsler Intelligence Scale for Children （ C-WISC ） before operation and 7 days after operation in two groups.Results A total of 84 children completed the study,T group was 27 cases,I group was 29 cases and control group was 28 cases.Each item score of C-WISC had no significance difference among three groups before surgery （all P〉0.05 ） .7 days after surgery,the scores of associative learning and digital symbols of I group were lower than before surgery and control group （all P〈0.05） ; the scores of associative learning,digital span and digital symbols of T group were lower than before surgery and control group （all P〈0.05） .While,the score of each item between T group and I group had no significance difference （all P〉0.05）.Conclusion General anesthesia may result in recent cognitive function damage for school-age patients.While,different methods of general anesthesia cause no difference extent of damage on the cognitive function.

关 键 词：术后认知功能障碍 全麻 儿童 

分 类 号：R726.8[医药卫生—儿科]