腰骶丛神经阻滞对老年术后患者认知功能、谵妄及情绪的影响  

Effects of lumbosacral plexus block on cognitive function,delirium and mood in elderly patients after hip surgery

作　　者：刘涛[1] 赵喜波 刘兆东 谭莹[1] LIU Tao;ZHAO Xibo;LIU Zhaodong(Sanmenxia Central Hospital,Sanmenxia 472000,China)

机构地区：[1]三门峡市中心医院,三门峡472000

出　　处：《国际精神病学杂志》2023年第5期1177-1179,共3页Journal Of International Psychiatry

基　　金：三门峡市科技发展计划(编号:2021004045)。

摘　　要：目的 探讨腰骶丛神经阻滞对老年髋部手术患者术后认知功能、谵妄及焦虑抑郁情绪的影响。方法 本研究对象为我院2021年3月~2022年5月收治的90例老年髋部手术患者,随机均分为对照组与观察组,对照组进行常规静吸复合麻醉,观察组在对照组基础上采用超声引导下腰骶丛神经阻滞。评估两组患者术前、术后1d、3d、5d时蒙特利尔认知评估量表(MoCA)、焦虑自评量表(SAS)、抑郁自评量表(SDS)以及术后认知功能障碍、谵妄发生率。结果 两组术后1d、3d MoCA评分均显著低于术前,SAS评分、SDS评分显著高于术前,且观察组各项指标优于对照组(P<0.05),两组术后7d与术前比较、组间比较差异无统计学意义(P>0.05),观察组术后认知功能障碍发生率、谵妄发生率均显著低于对照组(P<0.05)。结论 超声引导下腰骶丛神经阻滞能够降低老年髋部手术术后认知功能损害,降低认知功能障碍、谵妄发生率。Objective To investigate the effect of lumbosacral plexus block on cognitive function,delirium,anxiety and depression in elderly patients after hip surgery.Methods The subjects of this study were 90 elderly hip surgery patients admitted to our hospital from March 2021 to May 2022,and 90 subjects randomly divided into the control group and the observation group.The control group received conventional intravenous inhalation anesthesia,and the observation group received ultrasound-guided lumbosacral plexus block on the basis of the control group.The Montreal Cognitive Assessment Scale(MoCA),Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS)and postoperative cognitive dysfunction,self-rating anxiety scale(SAS),self-rating depression scale(SDS)and delirium incidence were evaluated in the two groups before operation,1d,3d,and 5d after surgery.Results The MoCA scores of the two groups at 1d and 3d after operation were significantly lower than those before operation,the SAS and SDS scores were significantly higher than those before operation,and the indexes in the observation group were better than those in the control group(P<0.05).There was no significant difference between the two groups on the 7th day after operation compared with before operation and between groups(P>0.05).The incidence of postoperative cognitive dysfunction and delirium in the observation group were significantly lower than those in the control group(P<0.05).Conclusion Ultrasound-guided lumbosacral plexus block can reduce the cognitive impairment injure and the incidence of cognitive impairment and delirium after hip surgery in elderly patients.

关 键 词：超声引导 腰骶丛神经阻滞 老年髋部手术 认知功能 谵妄 

分 类 号：R749[医药卫生—神经病学与精神病学]