全身麻醉和硬膜外麻醉对老年骨科患者术后短期认知功能的影响

Effects of different anesthetic techniques for postoperative Cognitive function in elderly orthopedic patients

目的探讨老年骨科患者不同麻醉方式对其术后短期认知功能的影响。方法将70例患者随机分为观察组和对照组,观察组采用硬膜外麻醉,对照组采用全身麻醉,对比两组患者麻醉前和术后6h、1d、3d及5d的MMSE评分、POCD发生率及不同麻醉方法对血清白介素1β(IL-1β)含量的影响。结果两组术后MMSE评分与麻醉前比较有统计学意义(P<0.05),而术后同期比较MMSE评分观察组与对照组差异有统计学意义(P<0.05);老年骨科患者认知功能障碍于术后6h,1d,观察组的发生率与对照组相比有统计学意义(P<0.05);对照组血清中的IL-1β与观察组比较明显升高,差异有统计学意义(P<0.05)。结论硬膜外麻醉对老年骨科患者术后认知功能影响轻,POCD发生率低,安全性高,值得临床选用。

Objective To investigate the general anesthesia and epidural anesthesia on postoperative cognitive function in elderly patients with orthopedic effect.Methods 70 patients were randomly assigned to observation group and control group,Compared two groups of patients before anesthesia and postoperative 6h,1d and 5d of the MMSE score,the incidence of POCD and different anesthesia on level of serum IL-1 Beta.Results Lower MMSE score of two groups of patients were compared with those before anesthesia.And the observation group MMSE score at different time after operation was higher than that of the control group,the difference was statistically significant（P0.05）;After 6h,1d POCD incidence of the observation group was significantly lower than the control group（P0.05）.Conclusion Epidural anesthesia on cognitive function in elderly patients in the department of orthopedics,postoperative effect of light,the rate of POCD was low,high safety,and is worthy of clinical use.