腰硬联合麻醉与单纯全身麻醉对老年骨折患者术后短期认知功能的影响

Effects of combined spinal-epidural anesthesia and simple general anesthesia on postoperative short-term cognitive function in elderly patients with fracture

目的探讨腰硬联合麻醉与单纯全身麻醉对老年骨折患者术后短期认知功能的影响。方法选取我院2022年1月~2023年10月收治的60例老年骨折患者为研究对象,根据随机数字表法分为两组。对照组(30例)接受单纯全身麻醉,研究组(30例)接受腰硬联合麻醉。比较两组患者术后认知功能、麻醉效果和并发症。结果麻醉前和麻醉后6 h、麻醉后12 h、麻醉后72 h,两组患者的简易精神状态量表(MMSE)评分相比,均无明显差异(P>0.05);麻醉后24 h,研究组患者的MMSE评分高于对照组,差异有统计学意义(P<0.05)。研究组患者的意识恢复时间、麻醉起效时间和完全清醒时间均短于对照组,差异有统计学意义(P<0.05)。研究组患者的并发症发生率(3.33%)低于对照组(26.67%),差异有统计学意义(P<0.05)。结论腰硬联合麻醉对老年骨折患者术后短期认知功能的影响低于单纯全身麻醉,且有利于改善麻醉效果,可以减少并发症的发生。

Objective To investigate the effects of combined spinal-epidural anesthesia and simple general anesthesia on postoperative short-term cognitive function in elderly patients with fracture.Methods A total of 60 elderly patients with fracture admitted to our hospital from January 2022 to October 2023 were selected as the study objects and divided into two groups according to random number table method.The control group(30 cases)received simple general anesthesia,and the study group(30 cases)received combined spinal-epidural anesthesia.The postoperative cognitive function,anesthesia effect and complications were compared between the two groups.Results Before anesthesia,6 h after anesthesia,12 h after anesthesia and 72 h after anesthesia,there was no significant difference in the mini mental state examinatoin(MMSE)score between the two groups(P>0.05).At 24 h after anesthesia,the MMSE score of the study group was higher than that of the control group,and the difference was statistically significant(P<0.05).The consciousness recovery time,anesthesia onset time and full awake time of the study group were shorter than those of the control group,and the difference was statistically significant(P<0.05).The complication rate of the study group(3.33%)was lower than that of the control group(26.67%),and the difference was statistically significant(P<0.05).Conclusion The effect of combined spinal-epidural anesthesia on postoperative short-term cognitive function in elderly patients with fracture is lower than that of simple general anesthesia,and it is beneficial to improve the anesthetic effect and reduce the incidence of complications.