不同麻醉方式对老年前列腺增生患者术后认知功能的影响

The influence of different anesthesia methods on postoperative cognitive function in elderly patients with benign prostatic hyperplasia

目的探讨不同麻醉方式对老年前列腺增生患者术后认知功能的影响。方法选择我院收治的60例老年前列腺增生患者,根据麻醉方式的不同将其平均分为观察组与对照组,各30例。观察组患者给予腰麻—硬膜外腔联合阻滞,对照组患者给予七氟醚全身麻醉,观察并对比两组患者的术中出血量、麻醉时间及术后1、5、9天的简易精神状态检查量表(MMSE)的评分。结果两组患者的术中出血量、麻醉时间比较,差异均没有统计学意义(P>0.05)。术后1天两组患者的MMSE评分均明显下降(P<0.05):术后5天,观察组的MMSE评分与术前1天比较,差异不显著(P>0.05),对照组MMSE评分明显低于术前1天(P<0.05);术后9天,两组患者的MMSE评分与术前1天比较,差异均不显著(P>0.05),而观察组在术后1、5天的MMSE评分均明显高于对照组(P<0.05)。结论与七氟醚全身麻醉相比,腰麻—硬膜外腔联合阻滞用于老年前列腺增生患者,对其术后认知功能影响较小,可使其认知功能较快恢复,值得临床推广应用。

Objective To investigate the influence of different anesthesia methods on postoperative cognitive function in elderly patients with benign prostatic hyperplasia. Methods Sixty cases of patients with benign prostatic hyperplasia were selected in our hospital, which was divided into observation group and control group according to different anesthesia methods. The observation group was given lumbar hemp-epidural space block, while the control group were given sevoflurane general anesthesia. The intraoperative blood loss, anesthesia time and mini-mental state examination （MMSE） score after surgery for 1, 5, 9 days of the patients in two groups were compared. Results There was no significant difference between the two groups in the amount of bleeding and the time of anesthesia （P〉0.05）. One day after operation, the MMSE scores of the two groups were significantly decreased （P〈0.05）. Five days after operation, the MMSE score of the observation group was not significantly different from that of the 1 day （P〉0.05）, while the MMSE score of the control group was significantly lower than that of the first 1 day （P〈0.05）. Nine days after operation, the MMSE scores of the patients in the two groups were not significantly different from those of the first 1 day （P〉0.05）. Otherwise, the MMSE score of the observation group was significantly higher than that of the control group on the 1, 5 day after operation （P〈0.05）. Conclusion Compared with sevoflurane general anesthesia, the lumbar hemp-epidural space block has less influence of postoperative cognitive function in elderly patients with benign prostatic hyperplasia, and the postoperative cognitive function after surgery recoverys more fast, which is worthy of clinical promotion and application.