全身麻醉与腰硬联合麻醉对老年下肢骨折患者术后认知功能的影响

Effect of General Anesthesia and Combined Spinal Epidural Anesthesia on Cognitive Function in Elderly Patients With Lower Limb Fracture

目的分析和比较全身麻醉与腰硬联合麻醉对老年下肢骨折患者术后认知功能的影响。方法选择2012年8月—2017年3月于我院骨科手术治疗下肢骨折的年龄≥60岁患者80例,其中观察组40例采用腰硬联合麻醉,对照组40例采用全身麻醉。结果两组患者术后1 d Mo CA迅速下降,此后逐渐升高,但术后7 d均未恢复至术前水平。术后1 d、3 d、7 d观察组Mo CA评分均高于对照组,差异有统计学意义(P<0.05)。结论老年下肢骨折患者术中采用腰硬联合麻醉术后认知功能障碍低于全身麻醉。

Objective To analyze and compare the effects of anesthesia and combined spinal and epidural anesthesia on cognitive function in elderly patients with lower limb fracture. Methods Eighty patients aged over 60 years from August 2012 to March 2017 in our hospital department of orthopedics for fracture patients were divided into 2 groups, the observation group of 40 cases were given lumbar epidural anesthesia, 40 cases of the control were given anesthesia. Results The 1 d MoCA of the two groups decreased rapidly and then increased gradually, but the postoperative 7 d did not recover to the preoperative level. The scores of 1 d, 3 d and 7 d in the observation group after operation were higher than those in the control group, the difference was statistically significant （P 〈 0.05）： Conclusion Combined spinal and epidural anesthesia for lower limb fracture in elderly patients is less than general anesthesia.