全身麻醉与硬膜外麻醉对老年骨科患者术后认知功能的影响

Effects of general anesthesia and Epidural Anesthesia on Postoperative Cognitive Function of Elderly Orthopedic Patients

目的:探讨不同麻醉方式对老年骨科患者术后短期认知功能的影响。方法:选择本院骨科收治的98例老年患者,随机分为全身麻醉组和硬膜外麻醉组,分别46例和52例,观察并比较两组的手术情况以及术后的认知功能。结果:两组各手术监测项目基础值和手术观察指标差异无统计学意义(P>0.05);两组术后12h的MMSE评分均明显下降,硬膜外麻醉组术后24h的MMSE评分明显高于全身麻醉组,差异具有统计学意义(P<0.05);硬膜外麻醉组术后24h的术后认知功能障碍(POCD)的发生率明显低于全身麻醉组,差异具有统计学意义(P<0.05)。结论:在老年骨科患者的手术中采用硬膜外麻醉对于术后认知功能的影响较小,POCD发生率较低,值得临床优先选用。

Objective：To observe the effects of different anesthesia methods on short-term cognitive function of elderly orthopedic patients. Method：98 elderly patients in our hospital were divided into general anesthesia group and epidural anesthesia group. There were 46 cases in general anesthesia group and 52 were cases in epidural anesthesia group. The operation status and postoperative cognition of the two groups were observed and compared. Results：There was no significant difference of baseline value and the operative observation between the two groups （P〉0.05）. The MMSE scores of the two groups were significantly lower than those before the operation （P〈0.05）. The incidence of postoperative cognitive dysfunction （POCD） was significantly lower in the epidural anesthesia group than in the general anesthesia group at 24 h postoperatively and the difference was statistically significant （P〈0.05）. Conclusion：Epidural anesthesia in elderly patients with orthopedic surgery has less influence on the postoperative cognitive function and the incidence of POCD is lower. It is worthy for clinical preference.