不同全身麻醉方法对老年患者术后认知功能的影响分析

Analysis of Effects of Different General Anesthesia Methods on Postoperative Cognitive Function in Elderly Patients

目的探讨不同的全身麻醉对老年患者术后认知功能的影响。方法将重庆市綦江区人民医院2010年2月至2011年2月之间收治的80例老年手术患者按照随机数字表法分为静吸复合麻醉组和全凭静脉麻醉组,静吸复合麻醉组给予静吸复合麻醉,全凭静脉麻醉组给予全凭静脉麻醉,两组均40例。观察患者术后认知功能情况。结果通过两组的观察比较,麻醉前全凭静脉麻醉组和静吸复合麻醉组简易精神状态量表(MMSE)评分比较无统计学意义(P>0.05);麻醉后两组患者的MMSE评分较麻醉前有显著改善,但全凭静脉麻醉组和静吸复合麻醉组的MMSE评分比较无统计学无意义(P>0.05)。全凭静脉麻醉组术后认知功能障碍(POCD)发生率为20.0%,静吸复合麻醉组术后POCD发生率为32.5%,全凭静脉麻醉组术后POCD发生率显著低于静吸复合麻醉组术后的发生率(P<0.05)。全凭静脉麻醉组术后恢复时间为(16.6±2.2)d,静吸复合麻醉组术后恢复时间为(17.3±2.0)d,两组比较无统计学无意义(P>0.05)。结论临床中对于老年患者给予静吸复合麻醉和全凭静脉麻醉均可行,且有效的改善患者术后认知功能,并降低POCD的发生,值得临床中应用。

Objective To investigate the effects of different general anesthesia methods on postoperative cognitive function in elderly patients. Methods Eighty cases of elderly patients to receive surgery in Chongqing Qijiang District People＇s Hospital between Feb. 2010 and Feb. 2011 were randomly divided into the intravenous and inhalation anesthesia group and total intravenous anesthesia group, 40 cases in each group. Postoperative cognitive function in patients were observed. Results By observing and comparing the two groups,there was no significant difference in Mini-Mental State Examination（MMSE） score between total intravenous anesthesia group and intravenous and inhalation anesthesia group （ P 〉 0.05 ） ; MMSE scores compared to before anesthesia of beth groups have improved significantly,but there was no significant differ- ence between total intravenous anesthesia group and intravenous and inhalation anesthesia group （P 〉 0.05 ）. POCD incidence of total intravenous anesthesia group was 20.0%, of intravenous and inhalation anesthesia group was 32.5% ,the former significantly lower than the latter（ P 〈 0.05 ）. Postoperative recovery time of total intravenous anesthesia group was （ 16.6 ± 2.2 ） d, of intravenous and inhalation anesthesia group was （ 17.3 ± 2.0 ） d, the difference was not statistically significant （ P 〉 0.05 ）. Conclusion Intravenous combined with inhalation anesthesia and total intravenous anesthesia are both feasible and effective in elderly patients in clinical, which can also improvie the postoperative cognitive function in patients and reduce the incidence of POCD,worthy of clinical application.