两种麻醉方式对老年患者骨科手术后认知功能与睡眠障碍影响的研究  

Effects of Two Anesthesia Methods on Cognitive Function and Sleep in Older Patients after Orthopedic Surgery

作　　者：史炯[1] 何平[1] 赵翠党 赵广平[1] 刘亚男[1] 陈永学[1] Shi Jiong;He Ping;Zhao Cuidang;Zhao Guangping;Liu Yanan;Chen Yongxue(Department of Anesthesiology,Handan Central Hospital,Handan 056000)

机构地区：[1]邯郸市中心医院麻醉科,邯郸056000

出　　处：《国际老年医学杂志》2021年第1期39-42,共4页International Journal of Geriatrics

基　　金：2019年度河北省医学科学研究课题计划(20191850)。

摘　　要：目的对比全身麻醉与硬膜外麻醉对老年患者骨科手术后认知功能与睡眠障碍的影响。方法选取邯郸市中心医院进行骨科手术治疗的老年患者108例,随机分为观察组与对照组,每组各54例。对照组患者采用全身麻醉法,观察组患者采用硬膜外麻醉,对两组患者术中的麻醉时间、手术时间、心率、睡眠质量、认知功能评分、认知功能障碍发生率及临床治疗满意度进行比较分析。结果两组患者术中麻醉时间、手术时间和心率之间的差异均无统计学意义(P>0.05);术后两组简易精神状态检查量表(MMSE)评分比较差异无统计学意义(P>0.05);术后观察组患者的匹兹堡睡眠质量指数(PSQI)评分低于对照组,差异具有统计学意义(P<0.001);术后观察组患者的认知功能障碍发生率低于对照组,治疗满意度高于对照组,差异均具有统计学意义(P<0.05)。结论对老年骨科手术患者,硬膜外麻醉患者认知功能障碍和睡眠功能障碍的发生率低于全身麻醉,且可提高患者的治疗满意度,推荐在临床应用。Objective To compare the effects of general anesthesia and epidural anesthesia on cognitive function and sleep in older patients after orthopedic surgery.Methods 108 older patients undergoing orthopedic surgery were collected from Handan Central Hospital.The patients were randomly divided into the observation group and the control group,54 cases in each group.The patients in the control group were given general anesthesia,while the patients in the observation group were given epidural anesthesia.The anesthesia time,operation time,heart rate,sleep quality,cognitive function,incidence of cognitive impairment,and treatment satisfaction were analyzed in the two groups.Results There were no significant differences in anesthesia time,operation time and heart rate between the two groups(P>0.05).After surgery,there was no significant difference in mini-mental state examination(MMSE)score between the two groups(P>0.05).The Pittsburgh sleep quality index(PSQI)score in the observation group was lower than that in the control group(P<0.001).The incidence of cognitive dysfunction was lower,and the treatment satisfaction was higher in the observation group than that in the control group(P<0.05).Conclusion For older patients undergoing orthopedic surgery,the incidences of cognitive dysfunction and sleep disorder in cases with epidural anesthesia might be lower than those in cases with general anesthesia.The epidural anesthesia could improve patients'satisfaction.

关 键 词：全身麻醉 硬膜外麻醉 认知功能障碍 睡眠障碍 

分 类 号：R614[医药卫生—麻醉学]