不同麻醉方式对老年患者术后认知功能障碍的影响

Comparison of postoperative cognitive dysfunction in elderly patients with different anesthesia

目的 探讨不同麻醉方式对老年患者术后认知功能的影响.方法 选择2010年1月～2013年1月行胃部手术的老年患者82例为研究对象,分为全凭静脉组（n=40）与静吸复合组（n=42）.观察患者的麻醉时间、术后睁眼时间、拔管时间.比较两组患者术前、术后24 h、术后3 d、术后7 d的认知功能.结果 两组患者麻醉时间比较,差异无统计学意义.静吸复合组术后睁眼时间、拔管时间明显长于全凭静脉组.两组患者术前和术后24 h认知功能比较,差异无统计学意义,术后3 d和术后7 d认知功能比较,差异有统计学意义.两组术后7 d认知功能障碍发生率比较,差异有统计学意义.结论 全凭静脉组术后苏醒时间更短,对患者认知功能的影响更小,老年患者应用相对安全性更高.

Objective To investigate the effects of different anesthesia on postoperative cognitive dysfunction in elderly patients. Methods From January 2012 to January 2013 , 82 elderly patients with stomach operation were divided into two groups, total intravenous group and intravenous inhalation combined group. Anesthesia time, postoperative time to eye opening,time of extubation,cognitive function in different time were compared. Results Anesthesia time of two groups had no difference. Postoperative time to eye opening and extubation time of intravenous inhalation combined group were significantly longer than the total intravenous group. Cognitive function score before operation and after op- eration 24 hours of two groups were no statistically significant. The cognitive function score between the 3 d postoperative day and the 7 d postoperative day showed statistically significance. 7 days after operation, the incidence of cognitive dysfunction indicated statistical significance. Conclusion Postoperative recovery time of the total intravenous group is shorter. Effect of cognitive function of patients is smaller. Elderly patients are relatively more secure.