CAJ | 학술논문

目的观察不同麻醉方法对老年患者术后认知功能的影响,选择最适宜老年患者使用的麻醉方式.方法选择上腹部择期手术老年患者40例,随机分为两组.观察组使用硬膜外复合气管插管全身麻醉;对照组采用单纯气管插管全身麻醉.观察并记录患者术中血流动力学变化.采用简易智力状态检查表(MMSE)评估患者术前24 h、术后24 h、术后48 h神经功能.结果两组患者生命体征平稳,MMSE评分差异无统计学意义(P>0.05);短期急性认知功能障碍者,术后24 h:观察组11例(55%),对照组13例(65%)(P>0.05);术后48 h,观察组5例(25%),对照组9例(45%)(P>0.05).结论同单纯全身麻醉相比,硬膜外复合全身麻醉对老年患者急性期认知功能影响较轻,更适于老年患者麻醉.
목적 관찰불동마취방법대노년환자술후인지공능적영향,선택최괄의노년환자사용적마취방식.방법 선택상복부택기수술노년환자40례,수궤분위량조.관찰조사용경막외복합기관삽관전신마취;대조조채용단순기관삽관전신마취.관찰병기록환자술중혈류동역학변화.채용간역지력상태검사표(MMSE)평고환자술전24 h、술후24 h、술후48 h신경공능.결과 량조환자생명체정평은,MMSE평분차이무통계학의의(P>0.05);단기급성인지공능장애자,술후24 h:관찰조11례(55%),대조조13례(65%)(P>0.05);술후48 h,관찰조5례(25%),대조조9례(45%)(P>0.05).결론 동단순전신마취상비,경막외복합전신마취대노년환자급성기인지공능영향교경,경괄우노년환자마취.
Objective To evaluate influence of general anesthesia on postoperative cognition function in the elderly patients by using different methods and choose a better anesthesia method for elderly patients. Methods Forty elderly patients undergoing selective abdominal surgery were selected and divided into two groups: anesthesia was maintained with general anesthesia combined with epidural anesthesia in observe group and with general anesthesia singlely in control group. Vital signs were observed and recorded during operation and blood pressure varied within the extent of 20% of basic level. Cognition function of each patient 24 hours before and 24,48 hours after operation was e-valuated by MMSE method. Results All the patients maintained steady vital signs and there was no significant differ-ence in MMSE scores between two groups at all the time points. There were 11 cases(55% ) who had acute cognitive dysfunction in observe group and 13 cases(65%) in control group 24h after operation(P>0.05) ,5 cases(25%) in observe group and 9 cases(45%) in control group 48h after surgery(P>0.05). Conclusion Compared with single general anesthesia, general anesthesia combined with epidural anesthesia uses less general anesthetics and has less negative effect on postoperative cognition funetion in the elderly patients,it maybe better in elderly patients undergoing non-cardiac operation.