不同麻醉方法对高龄骨科患者术后短期认知功能的影响  

Influence of different anesthesia methods on postoperative short-term cognitive function in elderly patients with department of orthopedics

作　　者：熊凯[1] 吴志瑛 

机构地区：[1]南昌大学第四附属医院麻醉科,江西南昌330000 [2]南昌大学附属三三四医院放疗科,江西南昌330024

出　　处：《中国当代医药》2017年第32期115-117,120,共4页China Modern Medicine

摘　　要：目的探讨高龄骨科患者应用不同麻醉方法对术后短期认知功能的影响。方法选择2014年1月~2017年1月在我院进行骨科手术的58例高龄患者,按照不同的麻醉方法分为腰硬联合麻醉(CSEA)组(n=30)与全身麻醉(GA)组(n=28)。记录两组患者麻醉后6、12、24、72 h的认知能力,观察麻醉前后的血压(BP)、心率(HR)的变化,并比较术后认知功能障碍(POCD)的发生情况。结果 CSEA组麻醉后6、12 h的MMSE评分与麻醉前比较,差异有统计学意义(P<0.05)。GA组麻醉后6、12、24 h的MMSE评分与麻醉前比较,差异有统计学意义(P<0.05)。CSEA组麻醉后24 h的MMSE评分与GA组比较,差异有统计学意义(P<0.05)。两组患者麻醉前后的BP、HR比较,差异无统计学意义(P>0.05)。CSEA组麻醉后的POCD发生率均低于GA组,两组麻醉后6、12 h的POCD发生率比较,差异有统计学意义(P<0.05)。结论腰硬联合麻醉方式对高龄骨科手术患者的短期认知功能明显小于全身麻醉,副作用相对较小。Objective To investigate the effect of different anesthesia methods on short-term cognitive function in elderly patients with department of orthopedics.Methods 58 elderly patients undergoing department of orthopedics surgery from January 2014 to January 2017 were divided into the combined spinal anesthesia （CSEA） group （n=30） and the general anesthesia （GA） group （n=28） according to different anesthesia methods.The cognitive ability of the two groups of patients after anesthesia 6,12,24,72 h were recorded.The changes of blood pressure （BP） and heart rate （HR） before and after anesthesia were observed,and the occurrence of post operative cognitive dysfunction （POCD） was compared3Results The MMSE scores of 6,12 h after anesthesia were compared with those before anesthesia in group CSEA,the difference was statistically significant （P〈0.05）.The MMSE scores of 6,12,24 h after anesthesia were compared with those before anesthesia in group GA,and the difference was statistically significant （P〈0.05）.The MMSE score of the 24 h in group CSEA and the GA group after anesthesia were statistically significant （P〈0.05）.There was no significant difference in the level of BP and HR between the two groups before and after anesthesia （P〈3.05）.The incidence of POCD after anesthesia in group CSEA was lower than that in group GA,and the difference of POCD between two groups of 6,12 h after anesthesia was statistically significant （P〈0.05）.Conclusion The short-term cognitive function of combined spinal anesthesia in elderly department of orthopedics patients is significantly less than general anesthesia,and the side effects are relatively small.

关 键 词：高龄骨科 腰硬联合麻醉 全身麻醉 认知功能 

分 类 号：R614.2[医药卫生—麻醉学]