腰硬联合麻醉对老年骨折合并高血压患者血流动力学及认知功能的影响  

Effects of Combined Spinal-Epidural Anesthesia on Hemodynamics and Cognitive Function in Elderly Fracture Patients with Hypertension

作　　者：潘月农 黄桂贤 许泽波 郝国明[2] PAN Yuenong;HUANG Guixian;XU Zebo;HAO Guoming(Department of Anesthesiology,Jinping District People's Hospital,Shantou 515041,China;Department of Anesthesiology,Shantou Central Hospital,Shantou 515041,China)

机构地区：[1]汕头市金平区人民医院麻醉科,广东汕头515041 [2]汕头市中心医院麻醉科,广东汕头515041

出　　处：《临床医学工程》2019年第10期1373-1374,共2页Clinical Medicine & Engineering

摘　　要：目的探讨腰硬联合麻醉对老年骨折合并高血压患者血流动力学及认知功能的影响。方法回顾性分析2018年1月至2018年12月在我院治疗的150例老年骨折合并高血压患者的临床资料,依据麻醉方法的不同分为观察组(腰硬联合麻醉)和对照组(气管插管静脉全身麻醉)。比较两组麻醉前后的血流动力学指标[平均动脉压(mean artery pressure,MAP)、心率(heart rate,HR)],以及手术前后的认知功能。结果麻醉前,两组患者的HR与MAP值比较,差异无统计学意义(P>0.05);麻醉后5 min与30 min,观察组患者的HR与MAP值均高于对照组,差异有统计学意义(P<0.05)。术前,两组患者的MMSE评分比较,差异无统计学意义(P>0.05);术后即刻与术后3 d,观察组患者的MMSE评分均高于对照组,差异有统计学意义(P<0.05)。结论腰硬联合麻醉对老年骨折合并高血压患者的血流动力学干扰小,对术后认知功能的影响轻微。Objective To investigate the effects of combined spinal-epidural anesthesia on hemodynamics and cognitive function in elderly fracture patients with hypertension.Methods The clinical data of 150 elderly fracture patients with hypertension treated in our hospital from January 2018 to December 2018 were retrospectively analyzed.According to the different anesthetic methods,patients were divided into observation group(combined spinal-epidural anesthesia)and control group(intravenous general anesthesia with tracheal intubation).The hemodynamics indicators[mean artery pressure(MAP),heart rate(HR)]before and after anesthesia,and the cognitive function before and after surgery were compared between the two groups.Results Before anesthesia,no significant difference was found in HR and MAP values between the two groups(P>0.05);5 minutes and 30 minutes after anesthesia,the HR and MAP values in the observation group were higher than those in the control group(P<0.05).Before operation,no significant difference was found in MMSE score between two groups(P>0.05);Immediately after operation and 3 days after operation,the MMSE scores in the observation group were higher than those in the control group(P<0.05).Conclusions Combined spinal-epidural anesthesia has little influence on hemodynamics and postoperative cognitive function in elderly fracture patients with hypertension.

关 键 词：老年骨折 高血压 腰硬联合麻醉 血流动力学 认知功能 

分 类 号：R683.42[医药卫生—骨科学]