中华老年医学杂志
中華老年醫學雜誌
중화노년의학잡지
Chinese Journal of Geriatrics
2014年
10期
1072-1074
,共3页
麻醉,全身%硬膜外麻醉%认知
痳醉,全身%硬膜外痳醉%認知
마취,전신%경막외마취%인지
Anesthesia,general%Anesthesia,epidural%Cognition
目的 探讨全身麻醉(全麻)联合硬膜外麻醉对老年骨科患者术后短期认知功能的影响. 方法 选择2011年1月至2014年1月于我院骨科手术治疗的185例老年患者,随机分为观察组和对照组,其中对照组91例,采用全身麻醉;观察组94例,采用全麻醉联合硬膜外麻醉.对比分析两组患者术后短期认知功能状态,以及术前30 min、手术操作时和手术结束时平均动脉压和心率.结果 术后苏醒时间、拔管时间和应答时间观察组患者分别为(28.7±7.8)min、(29.2±8.1)min、(30.4±7.9)min,对照组患者分别为(30.9±8.1)min、(32.2±8.4)min、(33.1±8.6)min,观察组均短于对照组(分别t=1.881、2.472、1.943,分别P=0.031、0.007、0.027).术后6、12和24 h简易精神状况检测量表(MMSE)评分分别为(26.1±1.4)分、(25.0±1.5)分、(27.9±1.4),对照组患者分别为(24.9±1.5)分、(24.1±1.4)分、(26.3±1.3)分,观察组均高于对照组(分别t=5.627、3.279、8.049,均P＜0.001).术后6h和术后12h认知功能障碍发生率观察组分别为7.5％和8.5％,对照组分别为17.6％和19.8％,观察组均低于对照组(分别x2=4.363、4.862,分别P=0.037、0.027). 结论 相比单纯全麻,全麻联合硬膜外麻醉可减轻麻醉对患者的认知功能障碍影响,且麻醉效果好,适合用于老年骨科患者手术麻醉.
目的 探討全身痳醉(全痳)聯閤硬膜外痳醉對老年骨科患者術後短期認知功能的影響. 方法 選擇2011年1月至2014年1月于我院骨科手術治療的185例老年患者,隨機分為觀察組和對照組,其中對照組91例,採用全身痳醉;觀察組94例,採用全痳醉聯閤硬膜外痳醉.對比分析兩組患者術後短期認知功能狀態,以及術前30 min、手術操作時和手術結束時平均動脈壓和心率.結果 術後囌醒時間、拔管時間和應答時間觀察組患者分彆為(28.7±7.8)min、(29.2±8.1)min、(30.4±7.9)min,對照組患者分彆為(30.9±8.1)min、(32.2±8.4)min、(33.1±8.6)min,觀察組均短于對照組(分彆t=1.881、2.472、1.943,分彆P=0.031、0.007、0.027).術後6、12和24 h簡易精神狀況檢測量錶(MMSE)評分分彆為(26.1±1.4)分、(25.0±1.5)分、(27.9±1.4),對照組患者分彆為(24.9±1.5)分、(24.1±1.4)分、(26.3±1.3)分,觀察組均高于對照組(分彆t=5.627、3.279、8.049,均P＜0.001).術後6h和術後12h認知功能障礙髮生率觀察組分彆為7.5％和8.5％,對照組分彆為17.6％和19.8％,觀察組均低于對照組(分彆x2=4.363、4.862,分彆P=0.037、0.027). 結論 相比單純全痳,全痳聯閤硬膜外痳醉可減輕痳醉對患者的認知功能障礙影響,且痳醉效果好,適閤用于老年骨科患者手術痳醉.
목적 탐토전신마취(전마)연합경막외마취대노년골과환자술후단기인지공능적영향. 방법 선택2011년1월지2014년1월우아원골과수술치료적185례노년환자,수궤분위관찰조화대조조,기중대조조91례,채용전신마취;관찰조94례,채용전마취연합경막외마취.대비분석량조환자술후단기인지공능상태,이급술전30 min、수술조작시화수술결속시평균동맥압화심솔.결과 술후소성시간、발관시간화응답시간관찰조환자분별위(28.7±7.8)min、(29.2±8.1)min、(30.4±7.9)min,대조조환자분별위(30.9±8.1)min、(32.2±8.4)min、(33.1±8.6)min,관찰조균단우대조조(분별t=1.881、2.472、1.943,분별P=0.031、0.007、0.027).술후6、12화24 h간역정신상황검측량표(MMSE)평분분별위(26.1±1.4)분、(25.0±1.5)분、(27.9±1.4),대조조환자분별위(24.9±1.5)분、(24.1±1.4)분、(26.3±1.3)분,관찰조균고우대조조(분별t=5.627、3.279、8.049,균P＜0.001).술후6h화술후12h인지공능장애발생솔관찰조분별위7.5％화8.5％,대조조분별위17.6％화19.8％,관찰조균저우대조조(분별x2=4.363、4.862,분별P=0.037、0.027). 결론 상비단순전마,전마연합경막외마취가감경마취대환자적인지공능장애영향,차마취효과호,괄합용우노년골과환자수술마취.
Objective To observe the effects of general anesthesia combined with epidural anesthesia on the short-term cognitive function in the elderly patients after orthopedics surgery.Methods 185 elderly patients undergoing orthopedics surgery were treated in our hospital from Jan.2011 to Jan.2014.The patients were divided into observation group (with general anesthesia combined with epidural anesthesia,n=94) and control group (with general anesthesia,n=91).The short term cognitive function,mean arterial pressure and heart rate were compared at 30 min before,during and at the end of the operation between the two groups.Results There were no statistically significant differences in awakening time,extubation time and response time between the two groups [(28.7±7.8) min vs.(30.9±8.1) min,(29.2±8.1) min vs.(32.2±8.4) min,(30.4±7.9) min vs.(33.1±8.6) min,t=1.881,2.472,1.943,respectively,P=0.031,0.007,0.027].The minimental state examination (MMSE) scores were higher in observation group than in control group at 6,12 and 24 hours after surgery [(26.1±1.4) vs.(24.9±1.5),(25.0±1.5) vs.(24.1±1.4),(27.9 ±1.4) vs.(26.3±1.3),t=5.627,3.279,8.049,all P＜0.001].The incidence of cognitive dysfunction was less in observation group than in control group at 6 and 12 hours after surgery (7.5％ vs.17.6％,8.5％ vs.19.8％,x2=4.363,4.862,respectively,P=0.037,0.027).Conclusions Compared with general anesthesia,the general anesthesia combined with epidural anesthesia can reduce the effects of anesthesia on cognitive dysfunction,and has a good effect of anesthesia.It is more suitable for the elderly patients with anesthesia for surgery.
