高龄髋关节置换术患者术中低血压与术后早期认知障碍的分析  

Analysis of Intraoperative Hypotension and Early Postoperative Cognitive Dysfunction in Elderly Patients With Hip Arthroplasty

作　　者：代景伟[1] 林梁[1] 冯宇峰[1] 陈振毅[1] DAI Jingwei;LIN Liang;FENG Yufeng;CHEN Zhenyi(Department of Anesthesiology, The First Afliated Hospital of Xiamen University, Xiamen Fujian 361022, China)

机构地区：[1]厦门大学附属第一医院麻醉科,福建厦门361022

出　　处：《中国继续医学教育》2018年第14期78-80,共3页China Continuing Medical Education

摘　　要：目的观察高龄患者髋关节置换术术中低血压与术后早期认知障碍的相关性。方法对2014年8月—2017年8月的104例(ASAⅠ~Ⅱ级)在本院择期行髋关节置换术的高龄患者资料进行回顾性分析。将104例患者按术中是否出现术中低血压,分为A组(n=50发生术中低血压)、B组(n=54未发术中生低血压)。所有患者均行髋关节置换术治疗,采用简易智能量表(MMSE)评估两组患者的认知功能。结果 A组、B组术后早期认知功能障碍发生率分别为36.0%(18/50)、11.1%(6/54),结果差异有统计学意义(P<0.05);两组患者术前1 d、术后2 d、术后3 d、术后4 d认知功能障碍发生率对比,差异无统计学意义(P>0.05);A组术后1 d发生早期认知功能障碍高于B组,差异有统计学意义(P<0.05)。结论高龄髋关节置换术患者发生术中低血压,将致术后早期认知功能障碍发生率明显升高。Objective To observe the correlation between intraoperative hypotension and early postoperative cognitive dysfunction in elderly patients with hip arthroplasty. Methods The data of 104 elderly patients （ASA class I to II） who underwent hip replacement in our hospital from August 2014 to August 2017 were retrospectively analyzed. The 104 patients were divided into group A （n=50, intraoperative hypotension） and group B （n=54, no intraoperative hypotension. according to whether they had intraoperative hypotension. All patients were treated with hip arthroplasty and the cognitive function of the two groups was assessed using the mini-mentalstate examination （MMSE）. Results The incidence of early postoperative cognitive dysfunction in group A and group B was 36.0% （18/50） and 11.1% （6/54）, there were significant diferences （P 〈 0.05）. In the two groups, the incidence of preoperative 1 d, postoperative 2 d, postoperative 3 d and postoperative 4 d cognitive impairment were compared, there were no significant difference （P 〉 0.05）; However, the early cognitive impairment in group A was higher than that in group B, there were significant differences （P 〈 0.05）. Conclusion The incidence of early postoperative cognitive dysfunction was signifcantly increased in elderly patients with hip arthroplasty with intraoperative hypotension.

关 键 词：高龄患者 髋关节置换术 术中低血压 术后认知功能障碍 

分 类 号：R687[医药卫生—骨科学]