不同麻醉方式对老年髋部骨折患者术后睡眠及术后谵妄发生率的影响

Effect of Different Anesthesia Methods on Postoperative Sleep and Postoperative Incidence in Elderly Patients with Hip Fracture

目的分析老年髋部骨折患者行手术治疗前不同麻醉方式对睡眠质量及术后谵妄发生率的影响。方法便利选择2020年7月—2021年8月于该院接受手术治疗的髋部骨折老年患者80例作为研究对象,根据患者麻醉方式不同进行分组,对照组患者均采取全身麻醉,观察组患者实施腰硬联合麻醉,记录对比两组患者相关手术指标,评估各组患者手术前后睡眠质量变化,观察统计两组患者发生术后谵妄的概率。结果两组患者手术时长、麻醉时间及术中出血量指标对比,差异无统计学意义(P>0.05)。术前评估两组患者睡眠质量各项评分对比,差异无统计学意义(P>0.05);观察组患者术后睡眠质量(5.13±1.02)分、睡眠时间(5.01±0.96)分、睡眠效率(5.20±1.01)分、睡眠药物(4.69±0.45)分及日间功能(6.11±0.14)分评分结果均明显低于对照组,差异有统计学意义(t=16.461、17.607、18.197、38.488、123.604,P<0.05)。观察组患者发生术后谵妄的概率低于对照组,差异有统计学意义(P<0.05)。结论老年髋部骨折患者采取腰硬联合麻醉效果更佳,对患者术后睡眠影响小,同时可有效减少患者术后谵妄情况的出现,安全性高,提倡运用且推广。

Objective To analyze the effects of different anesthesia methods in elderly patients with hip fractures before surgery on the quality of sleep and the incidence of postoperative delirium.Methods Conveniently selected 80 elderly patients with hip fractures who received surgical treatment in the hospital from July 2020 to August 2021 as the study objects.The patients were divided into groups according to different anesthesia methods.The patients in the control group were all given general anesthesia,and the patients in the observation group were given combined spinal-epidural anesthesia.The related surgical indicators of the two groups of patients were recorded and compared,the changes in sleep quality before and after surgery were evaluated in each group,and the probability of postoperative delirium in the two groups was observed and counted.Results There was no statistically significant difference in the operation time,anesthesia time and intraoperative blood loss between the two groups(P>0.05).There was no statistically significant difference in the scores of sleep quality between the two groups before surgery(P>0.05);the postoperative sleep quality(5.13±1.02)points,sleep time(5.01±0.96)points,sleep efficiency(5.20±1.01)points,sleep medication(4.69±0.45)points and daytime function(6.11±0.14)points of observation group were significantly lower than those of the control group,the difference was statistically significant(t=16.461,17.607,18.197,38.488,123.604,P<0.05).The probability of postoperative delirium in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion The effect of combined spinal-epidural anesthesia for elderly patients with hip fractures is better,and it has little effect on postoperative sleep.At the same time,it can effectively reduce the appearance of postoperative delirium in patients.It has high safety and is recommended and popularized.