全身麻醉与椎管内麻醉对老年骨科手术患者术后认知功能的影响  

Impact of general anesthesia and intravertebral anesthesia on cognitive function of elderly orthopaedic surgery patients

作　　者：金理照 丁梯杰 丁爱平[1] 

机构地区：[1]浙江省苍南县人民医院麻醉科,325800

出　　处：《中国全科医学》2017年第A02期153-155,共3页Chinese General Practice

摘　　要：目的探讨全身麻醉与椎管内麻醉对老年骨科手术患者术后认知功能的影响。方法选取苍南县人民医院2014年12月—2016年10月收治的老年骨科手术患者92例,随机分为对照组和试验组,各46例。对照组患者采用全身麻醉,试验组患者采用椎管内麻醉。比较两组患者术中出血量、手术时间及语言陈述时间;术后1.5、2.5、5.5、11.5、24 h简易精神状态检查量表(MMSE)评分,并观察患者低血压发生情况。结果两组患者术中出血量比较,差异无统计学意义(P>0.05);试验组患者手术时间、语言陈述时间短于对照组(P<0.05)。术前,两组患者MMSE评分比较,差异无统计学意义(P>0.05);术后1.5、2.5、5.5、11.5、24 h,试验组患者MMSE评分高于对照组(P<0.05)。试验组患者低血压发生率低于对照组(P<0.05)。结论与全身麻醉相比,椎管内麻醉可有效缩短老年骨科手术患者手术时间及语言功能恢复时间,对其认识功能影响小,且安全性较高。Objective To investigate the impact of general anesthesia and intravertebral anesthesia on cognitive function of elderly orthopaedic surgery patients. Methods A total of 92 cases of elderly orthopaedic surgery patients were selected from December 2014 to October 2016 in the People’ s Hospital of Cangnan,which were randomly divided into control group and experimental group,46 cases in each group. The control group was given general anesthesia,experimental group was given intravertebral anesthesia. The intraoperative blood loss, operation time, language statement time and MMSE scores of postoperative 1. 5,2. 5,5. 5,11. 5,24 h were compared between the two groups,and the incidence of low blood pressure was observed. Results No statistically significant difference of intraoperative blood loss was found between the two groups（ P 〉0. 05）; the experimental group of operation time and language statement time were shorter than control group（ P 〈 0. 05）.Before operation,no statistically significant difference of MMSE scores was found between the two groups（ P 〉 0. 05）; after postoperative 1. 5,2. 5,5. 5,11. 5,24 h, the experimental group of MMSE scores were higher than control group（ P 〈0. 05）. The low blood pressure rate of experimental group was lower than control group（ P 〈 0. 05）. Conclusion Intravertebral anesthesia can effectively shorten the operation time and language statement time of elderly orthopaedic surgery patients,and with less impact on cognitive function and higher safety.

关 键 词：骨科手术 老年 全身麻醉 椎管内麻醉 认知功能 

分 类 号：R614.1[医药卫生—麻醉学]