摘要
目的评价全身麻醉和椎管内麻醉对老年骨科手术患者术后精神状态及早期认知功能的影响。方法选择2017年5月~2019年5月期间本院收治的老年骨科手术患者100例,按照随机数字表法将其分为对照组(全身麻醉,n=50)及观察组(椎管内麻醉,n=50)。采用精神状态评价量表(MMSE)对患者术前及术后1h、3h、6h、24h、48h的精神状态进行评价,并以MMSE评分为依据对两组患者术后1h、3h、6h的认知障碍情况进行评定。结果两组患者实施麻醉前后的血流动力学比较无统计学意义(P>0.05);相比对照组,观察组手术时间、清醒时间、语言陈述时间均明显较短(P<0.05);术前两组患者MMSE评分无统计学意义(P>0.05)。而观察组术后各时间段的MMSE评分明显较对照组高(P<0.05);观察组术后各时间段的认知障碍、精神错乱发生率相比对照组均明显较少(P<0.05)。结论对老年骨科手术患者行椎管内麻醉可预防和减少患者术后认知功能障碍、精神异常等并发症的发生。
Objiective To evaluate the effects of general anesthesia and spinal anesthesia on postoperative mental status and early cognitive function in elderly patients undergoing orthopaedic surgery. Methods From May 2017 to May 2019,100 elderly patients undergoing orthopaedic surgery were enrolled and divided into control group(general anesthesia,n=50)and observation group(vertebral according to random number table method). The clinical effects of anesthesia,the mental status and cognitive function were compared between two groups. Results There was no significant difference in hemodynamics between the two groups before and after anesthesia(P>0.05). Compared with the control group,the operation time,awake time and language presentation time of the observation group were significantly shorter(P<0.05). There was no significant difference in MMSE score between the two groups before operation(P>0.05). The MMSE scores of the observation group were significantly higher than those of the control group(P<0.05). The incidence of cognitive impairment and mental confusion in the observation group was significantly lower than that in the control group(P<0.05). Conclusion Intra-arterial anesthesia for elderly orthopedic surgery can reduce the occurrence of postoperative cognitive dysfunction,mental disorder and other complications.
作者
曾举
ZENG Ju(Anyang People's Hospital,Anyang 45000,China)
出处
《国际精神病学杂志》
2020年第4期746-748,753,共4页
Journal Of International Psychiatry
关键词
老年骨科手术患者
全身麻醉
椎管内麻醉
精神状态
认知功能
Elderly orthopedic surgery patients
General anesthesia
Spinal anesthesia
Mental state
Cognitive function
作者简介
第一作者:曾举(1984.06),男,四川遂宁人,本科,主治医师,研究方向:老年麻醉;通讯作者:曾举(Email:zengjuren@126.com)。
