硬膜外麻醉用于老年股骨头置换术中对患者术后苏醒时间和认知功能的影响  

Effect of epidural anesthesia on postoperative recovery time and cognitive function in elderly patients undergoing femoral head replacement

作　　者：张秀丽 李静 ZHANG Xiuli;LI Jing(Department of Anesthesiology,Dezhou Second People's Hospital,Shandong Province,Dezhou,253000,China)

机构地区：[1]山东省德州市第二人民医院麻醉科,山东德州253000

出　　处：《中国当代医药》2023年第24期122-125,共4页China Modern Medicine

摘　　要：目的探究硬膜外麻醉用于老年股骨头置换术中对患者术后苏醒时间和认知功能的影响。方法回顾性分析2019年1月至2021年1月于德州市第二人民医院行股骨头置换术的80例老年患者的临床资料,根据手术麻醉方式的不同分为A组(49例)及B组(31例)。A组行连续硬膜外麻醉,B组行全身麻醉。比较两组的围手术期指标、术后苏醒状况、认知功能评分(MMSE)及并发症发生情况。结果A组的手术时间及恢复至术前状态时间均短于B组,术中出血量少于B组,差异有统计学意义(P<0.05)。A组的拔管时间、睁眼时间、应答时间、自主呼吸恢复时间均短于B组,差异有统计学意义(P<0.05)。A组的术后6、12、72 h MMSE评分均高于B组,差异有统计学意义(P<0.05)。A组的并发症总发生率低于B组,差异有统计学意义(P<0.05)。结论行股骨头置换术的老年患者应用硬膜外麻醉可获得较好的麻醉效果,能够有效缩短手术时间,减少术中出血量,尽早恢复术前状态,且患者术后苏醒时间较短,利于认知功能的恢复,并发症较少,安全可靠,值得推广应用。Objective To investigate the effects of epidural anesthesia on postoperative recovery time and cognitive function in elderly patients undergoing femoral head replacement.Methods The clinical data of 80 elderly patients undergoing femoral head replacement at the Second People's Hospital of Dezhou City from January 2019 to January 2021 were retrospectively analyzed.They were divided into group A(49 cases)and group B(31 cases)according to the different anesthetic methods of the surgery.Group A received continuous epidural anesthesia,while group B received general anesthesia.Perioperative indicators,postoperative recovery,cognitive function score(MMSE),and complication rates were compared between the two groups.Results The operation time and recovery time of group A were shorter than that of group B,and the intraoperative bleeding volume was less than that of group B,with statistically significant differences(P<0.05).The extubation time,eye opening time,response time,and spontaneous breathing recovery time in group A were shorter than those in group B,with statistically significant differences(P<0.05).The MMSE scores of group A at 6,12 and 72 h after operation were higher than those of group B,and the differences were statistically significant(P<0.05).The incidence of complications in group A was lower than that in group B,with a statistically significant difference(P<0.05).Conclusion The use of epidural anesthesia in elderly patients undergoing femoral head replacement can achieve better anesthetic effects,effectively shorten the operation time,reduce intraoperative bleeding,and restore preoperative status as soon as possible.Moreover,the patient has a shorter postoperative recovery time,which is conducive to the recovery of cognitive function,with fewer complications,and is safe and reliable,which is worth promoting and applying.

关 键 词：老年股骨头置换术 硬膜外麻醉 全身麻醉 术后苏醒时间 认知功能 

分 类 号：R614[医药卫生—麻醉学]