老年骨科手术全身麻醉和椎管内麻醉对术后精神状态和认知功能的影响

Effects of general anesthesia and spinal anesthesia on postoperative mental status and cognitive function in elderly patients with orthopedics

目的:探讨和分析老年骨科手术全身麻醉和椎管内麻醉对术后精神状态和认知功能的影响。方法:选择我院在2014年8月~2016年8月期间收治的78例老年骨科手术患者作为研究主体,按照患者入院顺序均分为A组和B组,每组各39例患者,A组患者行椎管内麻醉,B组患者行全身麻醉,对比A、B两组患者的手术指标情况、简易智力状态检查量表(Mini-mental state examination,MMSE)评分情况以及认知功能障碍发生情况。结果:A组患者的睁眼时间、手术时间、麻醉药剂量、语言陈述时间、MMSE评分、认知功能障碍发生率均优于B组患者(P<0.05)。结论:同全身麻醉相比较来说,椎管内麻醉在老年骨科手术患者中的应用效果更佳,明显改善了患者的精神状态,并且患者认知功能障碍发生的风险很小,值得推广。

Objective：To investigate and analyze the effects of general anesthesia and spinal anesthesia on postoperative mental status and cognitive function in elderly patients with orthopedics.Methods：Seventy-eight cases of elderly patients with orthopedics surgery in our hospital from August 2014 to August 2016 were selected and divided into group A and group B according to the order of admission,39 cases in each group.Patients in group A underwent spinal anesthesia,and patients in group B underwent general anesthesia.Surgical indicators,MMSE score and cognitive dysfunction between group A and group B were compared.Results：The open time,operation time,anesthesia time,anesthesia dose,declarative MMSE score,the incidence of cognitive dysfunction of patients in group A were better than group B（P〈0.05）.Conclusion：Compared with general anesthesia,spinal anesthesia has better application effect in elderly patients with orthopedics operation,it can significantly improve the patient′s mental state,and the risk of cognitive impairment in patients is small,worthy of promotion.