硬膜外麻醉与全身麻醉对老年骨科患者术后短期认知功能的影响比较被引量：5

Comparison of Effect of Epidural Anesthesia and General Anesthesia on the Short-term Cognitive Function of Senile Patients in the Department of Orthopedics after Surgery

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摘要目的比较分析硬膜外麻醉与全身麻醉对老年骨科患者术后短期认知功能的影响。方法选取该院2017年1—12月收治的老年骨科患者95例进行研究,所有患者均接受手术治疗,根据对患者采取的麻醉方式将其分为对照组(n=45)和观察组(n=50),对照组采用全身麻醉的方式,观察组采用硬膜外麻醉。对比两组患者术后的认知功能情况。结果观察组患者术前认知功能评分为(28.35±1.02)分,对照组术前认知功能评分为(28.45±1.18)分,差异无统计学意义(t=0.443,P=0.659),而观察组术后第1、7天认知功能评分分别为(20.95±2.32)分、(25.81±3.62)分,对照组术后第1、7天认知功能评分分别为(18.75±1.52)分、(22.89±2.14)分,对比差异有统计学意义(t=5.401,P=0.000;t=4.718,P=0.000)。但两组患者麻醉前、手术前、术中30 min、手术后的心率相比差异无统计学意义(P<0.05)。结论硬膜外麻醉措施在老年骨科患者手术中运用,能够提高患者认知功能评分,同时能够稳定患者的心率,患者手术期间的状态比较稳定,具有较高的临床应用价值。 Objective To compare and analyze the effect of epidural anesthesia and general anesthesia on the shortterm cognitive function of senile patients in the department of orthopedics after surgery. Methods 95 cases of senile orthopedic patients admitted and treated in our hospital from January to December 2017 were selected, and all patients received the surgery, and the patients were divided into two groups, the control group with 45 cases used the general anesthesia, while the observation group used the epidural anesthesia, and the cognitive function after surgery was compared between the two groups. Results The cognitive function score before surgery in the observation group and in the control group was respectively（28.35±1.02）points and（28.45±1.18）points, and the difference was not statistically significant（t=0.443, P=0.659）, and the cognitive function scores in 1 d and 7 d after surgery in the observation group and in the control group were respectively（20.95±2.32）points,（25.81±3.62）points and（18.75±1.52）points,（22.89±2.14）points,and the differences were statistically significant（t=5.401, P=0.000; t=4.718, P=0.000）, and the differences in the heart rate before anesthesia, before surgery, in 30 min and after surgery were not statistically significant（P〈0.05）. Conclusion The application of epidural anesthesia measures in the senile orthopedic patients can improve the cognitive function score, and stabilize the heart rate of patients, and the state of patients is steady during operation, and it is of higher clinical application value.

作者程俊 CHENG Jun(Department of Anesthesia,Nanehuan People＇ s Hospital,Chongqing,408400 China)

机构地区重庆市南川区人民医院麻醉科

出处《系统医学》 2018年第10期19-21,共3页 Systems Medicine

关键词硬膜外麻醉全身麻醉老年骨科认知功能 Epidural anesthesia General anesthesia Senile orthopedic Cognitive function

分类号 R614 [医药卫生—麻醉学]

作者简介程俊（1974-），男，重庆人，本科，主治医师，主要从事麻醉方面工作。