全身麻醉联合硬膜外麻醉对老年骨科患者术后认知功能的影响

Analysis on effects of general anesthesia and epidural anesthesia on postoperative cognitive function in elderly orthopedic patients

目的 探讨全身麻醉联合硬膜外麻醉对老年骨科患者术后认知功能的影响。方法 选取我院2014年10月-2015年6月收治的118例行骨科手术的老年患者作为研究对象,采用随机数字表法将所选患者分为研究组和对照组,各59例,研究组采用全身麻醉联合硬膜外麻醉,对照组采用全身麻醉。综合比较两组患者术后苏醒时间、拔管时间、应答时间、术后精神状态及认知功能障碍发生率。结果 研究组患者苏醒时间、拔管时间、应答时间分别为（29.3±4.6）、（30.6±4.1）、（31.7±3.9）min,均短于对照组（P〈0.05）;研究组患者术后4、12、24 h精神状况均优于对照组（P〈0.01）;术后各阶段研究组患者认知功能障碍发生率均低于对照组（P〈0.05）。结论 全身麻醉联合硬膜外麻醉可有效减轻老年骨科患者术后的认知功能障碍,优于单纯全身麻醉。

Objective To investigate the effects of general anesthesia and epidural anesthesia on postoperative cognitive function in elderly orthopedic patients. Methods 118 cases of elderly orthopedic patients in our hospital from October2014 to June 2015 were randomly divided into research group and control group,each were 59 cases.The research group were received general anesthesia and epidural anesthesia.The control group were received general anesthesia.The postoperative recovery time,extubation time,response time,postoperative mental state and cognitive dysfunction incidence rate were compared. Results The postoperative recovery time,extubation time and response time of research group was respectively（29.3±4.6）,（30.6±4.1）,（31.7±3.9）min,which was shorter than that of control group respectively（P〈0.05）.Postoperative 4,12,24 h,mental state of research group was better than that of control group respectively（P〈0.01）.The cognitive dysfunction incidence rate of research group was lower than control group（P〈0.05）. Conclusion General anesthesia combined with epidural anesthesia can effectively reduce postoperative cognitive dysfunction in elderly orthopedic patients.It′s better than general anesthesia alone.