不同麻醉药物对老年骨科手术患者术后认知功能的影响及机制

The effect and mechanism of different anesthetics on postoperative cognitive function of elderly patients with orthopedic surgery

目的:研究不同麻醉药物对老年骨科手术患者术后认知功能的影响及机制。方法:2015年4月-2018年9月选取行择期骨科手术老年患者160例,随机分为两组,各80例。对照组给予异氟烷进行维持麻醉;试验组给予七氟烷进行维持麻醉。对比两组麻醉效果。结果:对照组术后苏醒时间明显长于试验组,认知功能评分明显低于试验组,差异有统计学意义(P<0.05)。两组麻醉时间、手术时间和精神状态评分比较,差异无统计学意义(P>0.05)。结论:对老年骨科手术患者行七氟烷吸入性麻醉药物进行维持麻醉,能有效缩短患者苏醒时间,并降低患者认知功能障碍,其主要机制可能与老年患者中枢神经系统炎症有直接关系。

Objective:To explore the effect and mechanism of different anesthetics on postoperative cognitive function of elderly patients with orthopedic surgery.Methods:From April 2015 to September 2018,160 elderly patients with orthopedic surgery were selected and randomly divided into two groups of 80 cases in each.The control group was given isoflurane for maintenance anesthesia,and the experimental group was given sevoflurane for maintenance anesthesia.We compared the anesthetic effect of the two groups.Results:In the control group,the recovery time was significantly longer than that in the experimental group,and the cognitive function score was significantly lower than that in the experimental group,the difference was statistically significant(P<0.05).There was no significant difference in anesthesia time,operation time and mental state score between the two groups(P>0.05).Conclusion:Sevoflurane inhalation anesthesia for elderly patients with orthopedic surgery can effectively shorten the recovery time and reduce cognitive dysfunction.The main mechanism may be directly related to central nervous system inflammation in elderly patients.