全麻和硬膜外麻醉对老年骨科手术患者术后短期认知功能的影响  

Effects of general anesthesia and epidural anesthesia on postoperative cognitive function in elderly patients undergoing laparoscopic surgery

作　　者：冯念海 张玉柱[1] 

机构地区：[1]山东省淄博市中心医院麻醉科,山东淄博255036

出　　处：《中国现代医生》2017年第16期103-105,共3页China Modern Doctor

摘　　要：目的探讨对老年骨科手术患者分别采用全麻和硬膜外麻醉后对其认知功能的影响。方法选择本院2015年3月~2016年3月老年骨科手术患者60例,随机分为A组和B组,每组各30例。B组采取全身麻醉,A组采取硬膜外麻醉。观察两组术前术后MMSE评分的变化情况,对比分析两组患者术后认知功能障碍的发生率。结果 A组术前的MMES评分为(28.90±3.24)分,B组术前的MMES评分为(29.10±4.15)分,两组比较,差异无统计学意义(P>0.05);A组术后6 h、术后12 h、术后24 h的MMES评分均显著高于B组,差异有统计学意义(P<0.05);A组术后6 h、术后12 h的认知功能障碍发生率分别为3.3%、3.3%,均显著低于B组,差异有统计学意义(P<0.05),但A组与B组术后24 h的认知功能障碍发生率比较,差异无统计学意义(P>0.05)。结论老年骨科手术患者采用全麻和硬膜外麻醉效果均较好,但硬膜外麻醉有利于提高患者的认知功能、降低认知功能障碍的发生率。Objective To investigate the effect of general anesthesia and epidural anesthesia on cognitive function in elderly patients undergoing orthopedics surgery. Methods A total of 60 cases of elderly patients in department of orthopedics from March 2015 to March 2016 in our hospital were randomly divided into group A and group B, each group of30 cases. Group B received general anesthesia, group A received epidural anesthesia. The changes of MMSE score before and after operation in two groups were observed, and the incidence of postoperative cognitive dysfunction was compared between the two groups. Results In group A, preoperative MMES score was（28.90±3.24） points, the group B preoperative MMES score was（29.10±4.15） points, there was no statistically significant difference between the two groups（P〉0.05）;MMES scores of Group A at 6 h, 12 h, 24 h after surgery were significantly higher than those of the group B, the difference was statistically significant（P〈0.05）; The incidence of cognitive dysfunction of group A at 6 h and 12 h after operation was 3.3% and 3.3% respectively, significantly lower than those of the group B, the difference was statistically sig-nificant（P〈0.05）, but the incidence of cognitive dysfunction of group A and group B at 24 h after operation had no statistically significant difference（P〉0.05）. Conclusion The conclusion of the elderly patients in department of orthopedics surgery by general anesthesia and epidural anesthesia is better, but the epidural anesthesia can improve the cognitive function of patients, reduce the incidence of cognitive dysfunction.

关 键 词：老年 骨科手术 全麻 硬膜外麻醉 MMES评分 认知功能障碍 

分 类 号：R614[医药卫生—麻醉学]