腰硬联合麻醉对老年骨科患者术后短期认知功能的影响  

Effects of General Anesthesia and Combined Spinal Epidural Anesthesia on Postoperative Short-term Cognitive Function in Elderly Orthopedic Patients

作　　者：张善义 ZHANG Shanyi(Shandong Junan County People's Hospital,Linyi 276600,China)

机构地区：[1]山东省莒南县人民医院,山东临沂276600

出　　处：《中国医药指南》2020年第31期54-55,共2页Guide of China Medicine

摘　　要：目的探讨腰硬联合麻醉对老年骨科患者术后短期认知功能的影响。方法选择2018年12月至2019年12月山东省莒南县人民医院收治的82例老年骨科患者作为研究对象,根据患者手术麻醉方法的不同分为对照组(41例,采用全身麻醉方法)和观察组(41例,采用腰硬联合麻醉),比较两组患者治疗前后视觉模拟量表(VAS)评分、汉密尔顿焦虑量表(HAMA)评分、认知功能筛查量表(CASI)评分以及治疗期间不良反应发生情况。结果术前两组患者的VAS评分、HAMA评分、CASI评分比较,差异均无统计学意义(P>0.05);术后观察组患者的VAS评分、HAMA评分均明显低于对照组,术后24、48 h观察组患者的CASI评分明显高于对照组,差异均有统计学意义(P<0.05);在治疗期间观察组不良反应发生率明显低于对照组,差异有统计学意义(P<0.05)。结论针对老年骨科患者,采用腰硬联合麻醉的效果显著,且安全性高。Objective To investigate the effect of different anesthesia methods on postoperative cognitive function in elderly orthopedic patients.Methods From December 2018 to December 2019,82 cases of elderly orthopaedic patients as the research object,according to different patients anesthesia methods were divided into control group(41 cases,treated with general anesthesia method),the observation group(41 cases,treated with the waist hard joint anesthesia),collect and analyze the two groups before and after treatment in patients with visual analogue scale(VAS)score,Hamilton anxiety rating scale(HAMA)score,cognitive abilities screening instrument(CASI),cognitive function,and treatment of adverse reactions during the study.Results There was no significant difference in the VAS score,HAMA score,and CASI score between the two groups before operation(P>0.05);after operation,the VAS score and HAMA score of the observation group were significantly lower than those of the control group,the CASI score of patients in the observation group at 48 h was significantly higher than that of the control group,and the differences were statistically significant(P<0.05);during the treatment period,the incidence of adverse reactions in the observation group was significantly lower than that of the control group,and the difference was statistically significant(P<0.05).Conclusion Combined lumbar and epidural anesthesia is effective and safe for elderly orthopaedic patients.

关 键 词：骨科手术 老年 全身麻醉 腰硬联合麻醉 应激反应 认知功能 

分 类 号：R614[医药卫生—麻醉学] R816.8[医药卫生—外科学]