硬膜外复合全身麻醉在老年髋关节置换术中的疗效及对认知功能的影响  

Efficacy of Epidural Combined with General Anesthesia in Geriatric Hip Arthroplasty and the Effect on Cognitive Function

作　　者：高万露 吕洁[1] GAO Wanu;LYU Jie(Department of Anesthesiology,Nanjing Jiangning Hospital,Nanjing,Jiangsu Province,211100 China)

机构地区：[1]南京市江宁医院麻醉科,江苏南京211100

出　　处：《中外医疗》2022年第31期96-99,共4页China & Foreign Medical Treatment

摘　　要：目的 探讨老年髋关节置换术中应用硬膜外复合全身麻醉对认知功能及临床疗效产生的影响。方法方便选择2019年7月—2021年5月期间南京市江宁医院收治的84例老年髋关节置换术患者作为研究对象,按单双号分组的原则将其分为对照组、观察组,各42例,分别使用全身麻醉以及硬膜外复合全身麻醉,对两组麻醉效果展开对照分析。结果 观察组麻醉起效时间(52.44±6.54)s、术后拔管时间(16.73±2.54)min、术后睁眼时间(2.38±0.50)min、术后语言陈述时间(4.52±0.98)min均短于对照组,差异有统计学意义(t=6.318、12.147、13.498、11.720,P<0.05);观察组术后1、12、24 h认知功能评分分别为(19.50±1.70)分、(22.51±1.08)分、(23.49±2.51)分,均较对照组明显更高,差异有统计学意义(t=5.236、7.934、5.940,P<0.05);观察组术后苏醒期躁动发生率(16.67%)明显低于对照组,差异有统计学意义(χ^(2)=4.849,P<0.05)。结论 将硬膜外复合全身麻醉应用在老年髋关节置换术中,可以显著提升麻醉效果,改善患者认知功能,对控制术后苏醒躁动问题的产生具有诸多积极作用,因此适合深入探讨与普及使用。Objective To investigate the effects of epidural composite general anesthesia on cognitive function and clinical efficacy in geriatric hip arthroplasty.Methods 84 elderly hip arthroplasty patients admitted to Nanjing Jiangn⁃ing Hospital from July 2019 to May 2021 were conveniently selected as the study subjects.They were divided into the control group and the observation group according to the principle of single and double number grouping,with 42 cases in each group.General anesthesia and epidural compound general anesthesia were used respectively,and the an⁃esthetic effects of the two groups were analyzed in comparison.Results The anesthesia onset time(52.44±6.54)s,post⁃operative extubation time(16.73±2.54)min,postoperative eye opening time(2.38±0.50)min,and postoperative speech presentation time(4.52±0.98)min in the observation group were shorter than in the control group,the difference was statistically significant(t=6.318,12.147,13.498,11.720,P<0.05).The postoperative cognitive function scores at 1 h(19.50±1.70)points,12 h(22.51±1.08)points and 24 h(23.49±2.51)points in the observation group were significantly higher than the control group,the difference was statistically significant(t=5.236,7.934,5.940,P<0.05).The postop⁃erative agitation incidence during the awakening period of 16.67%observation group was significantly lower than that of the control group,the difference was statistically significant(χ^(2)=4.849,P<0.05).Conclusion Applying epidural composite general anesthesia in geriatric hip arthroplasty can significantly improve the anesthetic effect.It improves the cognitive function of patients and has many positive effects on controlling the generation of postoperative awaken⁃ing agitation problems,so it is suitable for in-depth discussion and popular use.

关 键 词：老年 髋关节置换术 全身麻醉 硬膜外麻醉 麻醉效果 认知功能 

分 类 号：R61[医药卫生—外科学]