CAJ | 학술논문

目的观察全身麻醉复合硬膜外阻滞麻醉对老年胸科手术患者应激反应及认知功能的影响。方法将我院收治的86例老年胸科手术患者按照麻醉方式的不同分为观察组与对照组，每组各43例，对照组患者采用全身麻醉，观察组患者采用全身麻醉复合硬膜外阻滞麻醉，观察两组患者不同时间段的皮质醇(Cor)、肾上腺素(E)及去甲肾上腺素(NE)变化情况，并采用简易精神状态检查表(MMSE)对患者的认知功能进行评价结果切皮后2h和切皮后4h观察组患者的Cor、E及NE水平明显低于对照组患者，组间差异有统计学意义(<0.05)。观察组患者术后1d和术后3d的MMSE评分均高于对照组患者，组间差异有统计学意义(<0.05)，认知功能优于对照组患者。结论全身麻醉复合硬膜外阻滞麻醉能够减轻老年胸科手术患者围手术期应激反应，改善患者术后的认知功能。
목적관찰전신마취복합경막외조체마취대노년흉과수술환자응격반응급인지공능적영향。방법장아원수치적86례노년흉과수술환자안조마취방식적불동분위관찰조여대조조，매조각43례，대조조환자채용전신마취，관찰조환자채용전신마취복합경막외조체마취，관찰량조환자불동시간단적피질순(Cor)、신상선소(E)급거갑신상선소(NE)변화정황，병채용간역정신상태검사표(MMSE)대환자적인지공능진행평개결과절피후2h화절피후4h관찰조환자적Cor、E급NE수평명현저우대조조환자，조간차이유통계학의의(<0.05)。관찰조환자술후1d화술후3d적MMSE평분균고우대조조환자，조간차이유통계학의의(<0.05)，인지공능우우대조조환자。결론전신마취복합경막외조체마취능구감경노년흉과수술환자위수술기응격반응，개선환자술후적인지공능。
Objective To observe the impact of combined general-epidural anesthesia on stress response and cognitive function of elderly patients who undergoing thoracic surgery.Methods 86 elderly cases who undergoing thoracic surgery in our hospital were divided into observation group and control group,43 cases in each group,cases in control group taken general anesthesia,cases in observation group taken combined general-epidural anesthesia,observed cortisol(Cor), epinephrine (E) and norepinephrine (NE)at dif erent period,and used the mini mental state examination (MMSE) to evaluate the cognitive function.Results Cor,E and NE levels after incision 2 and 5h of cases in observation group were significantly lower than that in control group, there was significant dif erence between two groups ( <0.05).MMSE scores after operation 1d and 3d of cases in observation group were higher than that in control group,there was significant dif erence between two groups ( <0.05),the cognitive function was bet er than control group.Conclusion Combined general-epidural anesthesia can reduce stress reaction and improve the cognitive function of elderly patients who undergoing thoracic surgery.