全身麻醉与硬膜外麻醉对老年患者术后认知功能的影响观察

Effects observation of general anesthesia and epidural anesthesia on postoperative cognitive function in elderly patients

目的探究不同麻醉方法对老年患者术后认知功能的影响。方法回顾性分析2013年12月至2016年12月于我院进行手术治疗的300例老年患者的临床资料。基于麻醉类型将其分为对照组和观察组,每组150例。对照组行全身麻醉,观察组行硬膜外麻醉。比较两组患者的智力状态评分与术后中枢神经系统并发症发生情况。结果对照组患者术后6、12、72 h的智力状态评分均低于术前,且低于观察组(P<0.05)。观察组患者术后6、12 h的智力状态评分低于术前(P<0.05),术后72 h的智力状态评分与术前比较,差异不显著(P>0.05)。观察组患者的术后中枢神经系统并发症总发生率为7.3%,明显低于对照组的16.7%,差异有统计学意义(P<0.05)。结论全身麻醉和硬膜外麻醉都会影响老年患者术后认知功能,但硬膜外麻醉对老年患者术后认知功能的影响更小,患者恢复快,临床效果佳,值得推广应用。

Objective To investigate the effect of different anesthesia methods on postoperative cognitive function inelderly patients. Methods The clinical data of 300 elderly patients who underwent surgical treatment in our hospital fromDecember 2013 to December 2016 in our hospital were analyzed retrospectively. The patients were divided into control group（n=150） and observation group （n=150） according to the different anesthesia methods. The control group received generalanesthesia, while the observation group received epidural anesthesia. The scores of intelligence state and postoperativecentral nervous system complications were compared between the two groups. Results The scores of intelligence state in thecontrol group at 6, 12, 72h after operation were lower than those before operation and in the observation group（P约0.05）. Thescores of intelligence state in the observation group at 6 and 12 h after operation were lower than those before operation（P〈0.05）, which at 72h after operation was not significantly different from before operation （P〉0.05）. The total incidence ofpostoperative central nervous system complications in the observation group was 7.3%, which was significantly lower than16.7% in the control group, the difference was statistically significant （P〈0.05）. Conclusion Both general anesthesia andepidural anesthesia can affect cognitive function of elderly patients, but epidural anesthesia has less effect, the patientsrecover quickly. It has a better clinical effect, and is worthy of promotion and application.