全麻和硬膜外麻醉对老年骨科患者手术后认知功能的影响

目的:评价全麻、硬膜外麻醉对老年骨科患者术后认知功能的影响进行评价。方法:将符合研究纳入标准的老年骨科患者设为研究参与对象,共180例,均于2013年1月份到2015年12月份在笔者医院进行治疗。以随机的方式分成对照组(n=90)和实验组(n=90),对照组接受全麻,实验组接受硬膜外麻醉。评价和观察患者术后认知功能的变化。结果:患者麻醉后不同时间段内均有患者出现认知功能障碍,麻醉后6h、麻醉后12h以实验组的认知功能障碍发生率较低,与对照组的指标比较经X2检验有统计学意义,P<0.05;患者麻醉后MESS分值明显下降,之后又逐渐恢复,麻醉后6h、麻醉后24h以及麻醉后72h实验组的MESS分值较高,与对照组的数据比较经T检验有统计学意义(P<0.05)。结论:全麻以及硬膜外麻醉对老年患者的术后认知功能均有影响,以硬膜外麻醉的影响较小,认知功能障碍发生率最低,值得推广。

Objective： To evaluate the effect of general anesthesia and epidural anesthesia on postoperative cognitive function in elderly patients with Department of orthopedics. Methods： Cases of elderly patients who were enrolled in the study were enrolled in the study. A total of 180 patients were treated in the hospital from January 2013 to December 2015. In a random way into the control group （n=90） and the experimental group （n=90）, the control group received general anesthesia, the experimental group received epidural anesthesia. Evaluation and observation of postoperative cognitive function in patients. Results： after anesthesia at different time period patients had appeared cognitive dysfunction, anesthesia after 6h, anesthesia after 12h to cognitive dysfunction in the experimental group occurred rate is low, and control group index compared by X^2 test was statistically significant, （P 〈 0.05）. The patients were anesthetized mess score decreased significantly, then gradually recovered, after anesthesia and 6h, 24h after anesthesia and anesthesia after 72h experimental group will score higher, and control group data compared by t test have statistical significance （P〈 0.05）. Conclusion： general anesthesia and epidural anesthesia on postoperative cognitive function in the elderly patients, the effect of epidural anesthesia is small, the incidence of cognitive dysfunction is the lowest, it is worth oromoting.