不同麻醉方式对老年经尿道前列腺电切术后患者认知功能的影响

Effects of different anesthesia methods on cognitive impairment after transurethral resection of prostate in elderly patients

目的探究不同麻醉方式对老年经尿道前列腺电切术(TURP)后患者认知功能的影响。方法选取山西白求恩医院2017年8月至2019年8月收治的需行经尿道TURP术的老年前列腺增生患者60例,按照麻醉方式分为观察组及对照组,每组30例。对照组行全身麻醉,观察组行腰硬联合阻滞麻醉。比较两组患者手术前后认知功能评分及认知功能障碍(POCD)的发生率。结果术后1周,观察组简易智能精神状态检查量表评分为(25.86±2.41)分,高于对照组的(24.16±2.12)分;画钟试验评分为(2.96±0.87)分,高于对照组的(2.05±0.64)分,差异有统计学意义(P<0.05)。观察组POCD发生率为13.33%(4/30),低于对照组的36.67%(11/30),两组比较差异有统计学意义(χ2=4.356,P<0.05)。结论较全身麻醉而言,腰硬联合阻滞麻醉可减少老年患者行TURP术后的POCD,更有利于术后1周患者认知功能水平的恢复。

Objective To investigate the effects of different anesthesia methods on postoperative cognitive dysfunction(POCD)of elderly patients after transurethral resection of prostate(TURP).Methods Sixty elderly patients with prostatic hyperplasia who were going to have transurethral TURP in Shanxi Bethune Hospital from August 2017 to August 2019 were selected.According to anesthetic methods,patients were divided into observation group and control group,with 30 patients in each group.The control group underwent general anesthesia,and the observation group underwent combined spinal-epidural block anesthesia.The preoperative and postoperative cognitive function scores and incidence of POCD were compared between the two groups.Results One week after operation,the mini-mental state examination score and clock drawing test score of the observation group were 25.86±2.41 and 2.96±0.87,respectively,which were significantly higher than 24.16±2.12 and 2.05±0.64 of the control group,correspondingly,P<0.05.The incidence of POCD in the observation group was 13.33%(4/30),which was lower than the 36.67%(11/30)in the control group,and the difference was statistically significant(χ2=4.356,P<0.05).Conclusions Compared with general anesthesia,combined spinal-epidural block anesthesia can reduce the incidence of POCD of elderly patients after TURP,and is more conducive to the recovery of cognitive function level of patients one week after operation.