实用临床医学
實用臨床醫學
실용림상의학
Practical Clinical Medicine
2014年
3期
49-51
,共3页
老年患者%术后认知功能障碍%硬脊膜外阻滞麻醉%全身麻醉
老年患者%術後認知功能障礙%硬脊膜外阻滯痳醉%全身痳醉
노년환자%술후인지공능장애%경척막외조체마취%전신마취
elderly patients%postoperative cognitive dysfunction%epidural anaesthesia%general anesthesia
目的：探讨不同麻醉方法对老年患者术后认知功能的影响。方法将110例拟行手术的老年患者按麻醉方法的不同分为2组：观察组和对照组，每组55例。观察组行硬脊膜外阻滞麻醉，对照组行全身麻醉。观察2组异丙酚、芬太尼使用量、术后疾病恢复时间及术后认知功能障碍发生的情况，并对2组麻醉前及术后6、24和72 h 采用简易精神状态量表（MMSE）进行认知功能评分。结果与对照组比较，观察组术后6、24和72 h MMSE得分、异丙酚使用量均明显升高（均P＜0.05），芬太尼使用量、术后认知功能障碍发生率均明显降低和术后疾病恢复时间明显缩短（均P＜0.05）。结论硬脊膜外阻滞麻醉较全身麻醉对老年患者术后认知功能影响轻，术后认知功能障碍发生率低，且不增加麻醉药量，对老年患者实行硬脊膜外阻滞麻醉是最佳的选择。
目的：探討不同痳醉方法對老年患者術後認知功能的影響。方法將110例擬行手術的老年患者按痳醉方法的不同分為2組：觀察組和對照組，每組55例。觀察組行硬脊膜外阻滯痳醉，對照組行全身痳醉。觀察2組異丙酚、芬太尼使用量、術後疾病恢複時間及術後認知功能障礙髮生的情況，併對2組痳醉前及術後6、24和72 h 採用簡易精神狀態量錶（MMSE）進行認知功能評分。結果與對照組比較，觀察組術後6、24和72 h MMSE得分、異丙酚使用量均明顯升高（均P＜0.05），芬太尼使用量、術後認知功能障礙髮生率均明顯降低和術後疾病恢複時間明顯縮短（均P＜0.05）。結論硬脊膜外阻滯痳醉較全身痳醉對老年患者術後認知功能影響輕，術後認知功能障礙髮生率低，且不增加痳醉藥量，對老年患者實行硬脊膜外阻滯痳醉是最佳的選擇。
목적：탐토불동마취방법대노년환자술후인지공능적영향。방법장110례의행수술적노년환자안마취방법적불동분위2조：관찰조화대조조，매조55례。관찰조행경척막외조체마취，대조조행전신마취。관찰2조이병분、분태니사용량、술후질병회복시간급술후인지공능장애발생적정황，병대2조마취전급술후6、24화72 h 채용간역정신상태량표（MMSE）진행인지공능평분。결과여대조조비교，관찰조술후6、24화72 h MMSE득분、이병분사용량균명현승고（균P＜0.05），분태니사용량、술후인지공능장애발생솔균명현강저화술후질병회복시간명현축단（균P＜0.05）。결론경척막외조체마취교전신마취대노년환자술후인지공능영향경，술후인지공능장애발생솔저，차불증가마취약량，대노년환자실행경척막외조체마취시최가적선택。
Objective To investigate the effects of different anesthesia methods on postoperative cognitive function in elderly patients. Methods A total of 110 elderly patients scheduled for surgery were assigned to receive either epidural anaesthesia (observation group,n=55) or general anesthesia (control group,n=55).The doses of propofol and fentanyl,postoperative recovery time and incidence of postoperative cognitive dysfunction were observed in both groups. Postoperative cognitive function was evaluated using the Mini-Mental State Examination (MMSE) before anesthesia and 6,24 and 72 hours after operation. Results Compared with control group,epidural anaesthesia increased MMSE score and propofol dose, decreased fentanyl dose and incidence of postoperative cognitive dysfunction,and shortened postoperative recovery time 6,24 and 72 hours after operation (P<0.05).Conclusion Epidural anaesthesia exerts milder effect and results in lower incidence of postoperative cognitive dysfunction than general anesthesia. Furthermore, epidural anaesthesia does not increase the dose of anaesthetic. Therefore, epidural anaesthesia is the optimal choice for elderly patients.
