麻醉深度对老年患者全髋置换手术后意识障碍的影响

Influence of anesthesia depth on consciousness disturbance in elderly patients after total hip replacement surgery

目的探讨麻醉深度对老年患者全髋置换手术后意识障碍的影响。方法选取我院2020年1月~2021年12月收治的50例老年全髋置换手术患者作为研究对象,通过随机数字表法,将患者分为实验组和对照组,每组25例。对照组患者术中的脑电双频指数控制在45-60之间,实验组患者术中的脑电双频指数控制在30-45之间。统计对比两组患者的麻醉时间、手术出血量、苏醒时间、拔管时间、术后3hMMSE、术后1dMMSE、7dMMSE以及患者的治疗满意度。结果实验组患者术后苏醒时间、拔管时间、术后3hMMSE、术后1dMMSE以及术后7dMMSE的评分均高于对照组,对比差异显著具有统计学意义(P<0.05)。实验组患者麻醉时间、手术出血量、7dMMSE的评分与对照组对比无显著差异,不具有统计学意义(P>0.05)。实验组患者的治疗满意度(96.0%)明显高于对照组(84.0%),对比差异显著具有统计学意义(P<0.05)。结论老年患者全髋置换手术中增加患者的麻醇深度可以有效改善患者的术后意识障碍,减轻患者的痛苦,提高患者的治疗满意度和生活质量,值得广泛应用。

Objective To investigate the effect of anesthesia depth on consciousness disorder after total hip replacement in elderly patients.Methods 50 elderly patients with total hip arthroplasty treated in ourhospital from January 2020 to December 2021 were selected as the research object.Through the method of random number table,the patients were divided into experimental group and control group,with 25 cases in each group.The intraoperative bispectral index of EEG in the control group was controlled between 45-60,and the intraoperative bispectral index of EEG in the experimental group was controlled between 30-45.The anesthesia time,surgical bleeding,recovery time,extubation time,postoperative 3H MMSE,postoperative ID MMSE,7d MMSE and treatment satisfaction of the two groups were statistically compared.Results The scores of postoperative recovery time,extubation time,postoperative 3-h MMSE,postoperative 1-D MMSE and postoperative 7-d MMSE in the experimental group were significantly higher than those in the control group(P<0.05).There was no significant difference between the experimental group and thecontrol group in anesthesia time,surgical bleeding and 7-day MMSE score(P>0.05).The treatment satisfaction of patients in the experimental group(96.0%)was significantly higher than that in the control group(84.0%).The difference was statistically significant(P<0.05).Conclusion Increasing the depth of anesthesia in elderly patients undergoing total hip arthroplasty can effectively improve their postoperative consciousness disorder,reduce their pain,and improve their treatment satisfaction and quality of life.It is worthy of wide application.