不同麻醉方法对老年患者术后认知功能的影响

Influence of different anesthetic methods on postoperative cognitive function effects in elderly patients

目的探讨全身麻醉与硬膜外麻醉对老年患者术后认知功能的影响。方法选择64例60岁以上择期行膀胱肿瘤电切术的患者,随机分为A组(全身麻醉)和B组(硬膜外麻醉)。于术前、术后6h及术后第1、3、7天进行MMSE评分,比较两组术后认知功能障碍(POCD)的发生率。结果两组患者术后MMSE评分均较术前显著下降,B组MMSE评分高于A组,差异有统计学意义(P<0.05);术后第3天,B组恢复至术前水平;术后第7天,两组均恢复至术前水平。术后6 h和术后第1、3天,B组POCD的发生率低于A组,差异有统计学意义(P<0.05)。结论硬膜外麻醉对老年患者术后早期认知功能的影响程度低于全身麻醉。

Objective To probe into the influence of different anesthetic methods on postoperative cognitive function effects in elderly patients. Methods 64 patients over 60 years of age who underwent elective surgery for bladder tumor were selected,and these patients were randomly divided into the group A（ general anesthesia） and the group B（ epidural anesthesia）. Before operation,the postoperative 6h,and postoperative day1,3,7,the MMSE score were performed,the difference between the two groups was compared and the incidence of postoperative cognitive dysfunction（ POCD） was statistically compared. Results The MMSE scores after the operation of the two groups were significantly decreased compared with before the operation,the MMSE score of B group was higher than that of group A,and the difference was significant（ P 0. 05）; Third days after operation,the B group were recovered to before the operation level. Seven days after operation,the two groups all recovered to before the operation level. Before operation of 6h and after operation of 1,3 day,the incidence of POCD in group B was lower than that in group A,and the difference was significant（ P 0. 05）. Conclusions The degree of influence of epidural anesthesia on early postoperative cognitive function in elderly patients are lower than that of general anesthesia.