CAJ | 학술논문

目的：观察老年骨科手术患者行全身麻醉和硬膜外麻醉对术后认知功能的影响。方法选择200例行骨科大手术的老年患者，分为观察组和对照组各100例，观察组行硬膜外麻醉，对照组行全身麻醉，使用简易精神状况检查量表（MMSE）对2组老年患者麻醉前后的不同时间点认知功能进行评估。结果两组患者麻醉前MMSE评分无统计学差异（P＞0.05）；对照组麻醉后6、12、24h的MMSE评分与本组麻醉前比较存在明显差异（均P＜0.01）；观察组麻醉后6、12h的MMSE评分与本组麻醉前比较存在明显差异（均P＜0.01）；两组患者麻醉后12、24h的MMSE评分存在明显差异（P＜0.01）。结论老年骨科手术患者行全身麻醉和硬膜外麻醉后24h内均出现认知功能障碍，全身麻醉对术后认知功能的影响更明显。
목적：관찰노년골과수술환자행전신마취화경막외마취대술후인지공능적영향。방법선택200례행골과대수술적노년환자，분위관찰조화대조조각100례，관찰조행경막외마취，대조조행전신마취，사용간역정신상황검사량표（MMSE）대2조노년환자마취전후적불동시간점인지공능진행평고。결과량조환자마취전MMSE평분무통계학차이（P＞0.05）；대조조마취후6、12、24h적MMSE평분여본조마취전비교존재명현차이（균P＜0.01）；관찰조마취후6、12h적MMSE평분여본조마취전비교존재명현차이（균P＜0.01）；량조환자마취후12、24h적MMSE평분존재명현차이（P＜0.01）。결론노년골과수술환자행전신마취화경막외마취후24h내균출현인지공능장애，전신마취대술후인지공능적영향경명현。
Objectives To observe the effects of of general anesthesia and epidural anesthesia on postoperative cognitive function in geriatric orthopaedic patients. Methods 200 geriatric patients for orthopaedic surgery were divided into treatment group and control group with 100 cases each group. Treatment group were given epidural anesthesia. Control group were given general anesthesia. The cognitive functions of two groups were observed using MMSE. Results There was no statistical difference of the two groups before anesthesia (P>0.05). In control group, the MMSE difference of 6 h, 12 h and 24 h after anesthesia compared with that before anesthesia was statistically signiifcant (P<0.01), and similarly in treatment group the MMSE difference statistically signiifcant (P<0.01). 12 h and 24 h after anesthesia, the MMSE difference of the two groups were statistically signiifcant (P<0.01). Conclusions Geriatric orthopaedic patients suffered cognitive dysfunction within 24 h after anesthesia. The effect of general anesthesia were more obvious than epidural anesthesia.