全身麻醉和椎管内麻醉对老年髋关节置换术患者围手术期的影响对比  

Comparsion of Perioperative Effects of General Anesthesia and Intraspinal Anesthesia on Elderly Patients Undergoing Hip Replacement

作　　者：孙会珍 SUN Huizhen(Department of Anesthesia Operating Room,Guangrao County People’s Hospital,Dangylng 257000,China)

机构地区：[1]山东省广饶县人民医院麻醉手术室,山东东营257000

出　　处：《中国伤残医学》2024年第22期91-95,共5页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:分析全身麻醉和椎管内麻醉在老年髋关节置换术患者围手术期的应用效果。方法:回顾性分析2023年1月-2024年9月广饶县人民医院收治的60例老年股骨颈骨折患者资料,所有患者均行髋关节置换手术。根据麻醉方法的不同将其分为对照组及研究组,各30例。对照组采用全身麻醉,研究组采用椎管内麻醉。对比两组的血流动力学、脑动-静脉氧含量差值及认知功能、精神状态。结果:手术开始后20 min、离开麻醉苏醒室时,两组的心率、动脉压均较麻醉前升高,但研究组均低于对照组,差异均有统计学意义(P<0.05)。手术开始后20 min、离开麻醉苏醒室时,两组的脑动-静脉氧含量差值均较麻醉前减小,且研究组小于对照组,差异均有统计学意义(P<0.05)。术后6、24 h,研究组蒙特利尔认知评估量表评分及简易精神状态检查量表评分均高于对照组,差异均有统计学意义(P<0.05)。结论:椎管内麻醉可最大程度减轻对老年髋关节置换术患者术后认知功能和精神状态的影响,稳定其血流动力学及脑动静脉氧含量具有一定的应用价值。Objective:To analyze the effects of general anesthesia and intraspinal anesthesia in elderly patients undergoing hip replacement during perioperative period.Methods:Data of 60 elderly patients with femoral neck fracture admitted to Gugrao County People’s Hospital from January 2023 to September 2024 were retrospectively sanalyzed.All patients underwent hip replacement surgery.According to different anesthesia methods,they were divided into a control group and a study group,with 30 cases in each group.The control group was given general anesthesia,and the study group was given intraspinal anesthesia.The hemodynamics,the difference of brain arteriovenous oxygen content,cognitive function and mental state were compared between the two groups Results:At 20min after the start of surgery and leaving the anesthesia awakening room,the heart rate and arterial pressure of the two groups were higher than those before anesthesia,but the heart rates and arterial pressures of the study group were lower than those of the control group,and the differences were statistically significant(P<0.05).At 20min after the start of surgery and leaving the anesthesia awakening room,the cerebral arteriovenous oxygen differences of the two groups were less than those before anesthesia,and the study group was less than the control group,and the differences were statistically significant(P<0.05).At 6 h and 24 h after surgery,the Montreal Cognitive Assessment score and Mini-Mental State Examunation score of the study group were higher than those of the control group,the differences were statistically significant(P<0.05).Conclusion:Intravertebral anesthesia can minimize the effects on cognitive function and mental state of elderly patients after hip replacement,stabilizing hemodynamics and the difference of cerebral arteriovenous oxygen content has certain application value..

关 键 词：髋关节置换术 老年患者 全身麻醉 椎管内麻醉 认知功能 

分 类 号：R614[医药卫生—麻醉学]