摘要
目的探讨不同麻醉方式对老年下肢创伤患者术后早期认知功能的影响情况,寻求理想的麻醉方式用于临床推广使用。方法以该院2011年3月—2012年3月行股骨手术的老年患者100例为研究对象,将其按麻醉方式的不同分为两组。其中56例研究对象,使用全身麻醉,为对照组;44例研究对象使用单侧腰-硬联合麻醉,为观察组。使用神经心理学测试技术评定研究对象手术前及术后的认知功能并进行比较,同时进行组间比较;对两组研究对象麻醉前后进行MMSE评分,并进行比较及组间比较,并对组间比较进行统计学分析。结果手术前两组研究对象的认知功能比较,差异无统计学意义(P>0.05);术后均较术前有所下降,但差异无统计学意义(P>0.05);在术后认知功能的比较中,观察组较对照组有明显优势,且差异有统计学意义(P<0.05);对研究对象麻醉前MMSE评分进行比较,两组研究对象差异无统计学意义(P>0.05);术后观察组的MMSE评分优于对照组,且差异有统计学意义(P<0.05)。结论腰-硬联合麻醉应用于老年创伤患者手术中具有对认知功能影响小,MMSE变化小,患者能早期回到正常的生活环境,是目前老年下肢创伤手术较为理想的麻醉方式。
Objective To conduct a comparative analysis of anesthesia on cognitive function in elderly trauma patients, seeking the ideal anesthetic for clinical use. Methods To our hospital in March 2011 - March 2012 line femur surgery 100 cases of elderly patients for the study, and were divided into two groups of different anesthesia. Study of 56 cases using general anesthesia for the control group; 44 subjects were unilateral spinal - epidural anesthesia, the observation group. Compare neuropsychological testing technology assessment study prior to surgery and postoperative cognitive function and compare, and comparison between groups; MMSE score of the two groups of subjects before and after anesthesia, and the comparison groups, and group comparison between statistical analysis. Results No significant difference in the cognitive function of the results of the two groups of subjects before surgery, no significant difference（P〉 0.05）; postoperative compared with preoperative declined, but there was no significant differ- ence （19〉 0.05 ）; comparison of postoperative cognitive function in the observation group than in the control group had a clear ad- vantage, and has a significant difference （P 〈0.05）; study compared two groups of subjects before anesthesia MMSE score was no significant difference and not statistically significant（P〉 0.05）; postoperative MMSE score of the observation group than the control group, with a statistically significant difference （P 〈0.05）; the POCD incidence of postoperative two groups of subjects to compare the observed group POCD incidence of 13.6% was significantly lower than the control group, a significant difference （P 〈0.05）. Conclusion Waist - epidural anesthesia used in the surgery of elderly trauma patients have a small impact on cognitive function, small changes in the MMSE, POCD incidence The low advantage is the ideal anesthesia.
出处
《中外医疗》
2013年第13期15-16,共2页
China & Foreign Medical Treatment
