全身麻醉和硬膜外麻醉对老年骨科患者术后短期认知功能的影响(1)
【摘要】 目的：探讨全身麻醉和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：选取2017年2月-2018年2月入院接受治疗的134例老年骨科患者，采用双色球分组法将患者分为对照组与观察组，每组67例。两组接受不同麻醉方式，对照组接受全身麻醉，观察组接受硬膜外麻醉，观察两组认知障碍情况。结果：观察组认知障碍发生率低于对照组，差异有统计学意义(P<0.05)。观察組麻醉后苏醒时间、应答时间、拔管时间均早于对照组，差异均有统计意义(P<0.05)。结论：硬膜外麻醉对于老年骨科患者的认知功能影响较小，能有效降低发生认知障碍的风险，值得在临床上推广。
【关键词】 全身麻醉; 硬膜外麻醉; 老年骨科患者; 术后短期认知; 认知障碍发生率; 麻醉效果
doi：10.14033/j.cnki.cfmr.2019.22.010 文献标识码 B 文章编号 1674-6805(2019)22-00-03
【Abstract】 Objective：To explore the effects of general anesthesia and epidural anesthesia on postoperative short-term cognition in elderly orthopaedic patients.Method：A total of 134 patients were admitted to hospital for treatment from February 2017 to February 2018 and divided into the control group and the observation group by the double chromosphere grouping method，67 cases in each group.The patients in the two groups received different anesthesia methods，the patients in the control group received general anesthesia，the patients in the observation group received epidural anesthesia，and the cognitive impairment of the patients in the two groups were observed.Result：Incidence of cognitive impairment in the observation group was lower than that of the control group，and the difference was statistically significant(P<0.05).The recovery time，response time and extubation time after anesthesia of the observation group were earlier than those of the control group，and the differences were statistically significant(P<0.05).Conclusion：Epidural anesthesia has relatively less influence on cognitive impairment of elderly orthopedic patients and can effectively reduce the risk of cognitive impairment，which is worthy of clinical promotion.
【Key words】 General anesthesia; Epidural anesthesia; Elderly orthopedic patients; Postoperative short-term cognition; Incidence of cognitive impairment; Anesthetic effect
First-author’s address：Yingcheng People’s Hospital，Yingcheng 432400，China
术后短期认知功能障碍是老年患者在接受骨科手术后，出现的短暂中枢神经系统功能异常的症状，也是一种较为常见的术后并发症，患者会出现记忆力减退、精神萎靡及负性情绪等表现。相对于年轻患者而言，老年患者机体恢复能力较弱，手术后发生认知障碍的概率更高，针对此现象，必须选择一种合适的麻醉方式，以降低患者发生认知功能障碍的风险[1-3]。在患者接受骨科手术时需要进行麻醉，麻醉方式可选择硬膜外麻醉、全身麻醉等[4-5]。为了探究硬膜外麻醉、全身麻醉对老年骨科患者术后短期认知功能的影响，采用双色球分组法将纳入研究的134例患者均分为两组，对照组接受全身麻醉，观察组接受硬膜外麻醉，将本次研究结果报道如下。
1 资料与方法
1.1 一般资料
选取2017年2月-2018年2月入院接受治疗的134例老年骨科患者。纳入标准：(1)均为老年骨科手术患者;(2)精神状况、语言表达、沟通能力、理解能力尚可。排除标准：(1)患有严重且需要临床干预的心脏疾病、肝肾疾病、重要器官衰竭等;(2)患有活动性传染疾病;(3)同时患有两种原发癌;(4)依从性较差;(5)不愿参与研究。采用双色球分组法将患者分为对照组与观察组，每组67例。对照组男41例，女26例;年龄62～84岁，平均(70.74±2.94)岁。观察组男35例，女32例;年龄60～85岁，平均(70.34±2.86)岁。笔者将两组一般资料使用统计学软件进行分析，差异均无统计学意义(P>0.05)。本次研究获得医学伦理会的支持，患者对研究内容知情，经笔者回答患者与家属疑问后，均自愿签署知情同意书。, http://www.100md.com(汪伟 张雪莲)
【关键词】 全身麻醉; 硬膜外麻醉; 老年骨科患者; 术后短期认知; 认知障碍发生率; 麻醉效果
doi：10.14033/j.cnki.cfmr.2019.22.010 文献标识码 B 文章编号 1674-6805(2019)22-00-03
【Abstract】 Objective：To explore the effects of general anesthesia and epidural anesthesia on postoperative short-term cognition in elderly orthopaedic patients.Method：A total of 134 patients were admitted to hospital for treatment from February 2017 to February 2018 and divided into the control group and the observation group by the double chromosphere grouping method，67 cases in each group.The patients in the two groups received different anesthesia methods，the patients in the control group received general anesthesia，the patients in the observation group received epidural anesthesia，and the cognitive impairment of the patients in the two groups were observed.Result：Incidence of cognitive impairment in the observation group was lower than that of the control group，and the difference was statistically significant(P<0.05).The recovery time，response time and extubation time after anesthesia of the observation group were earlier than those of the control group，and the differences were statistically significant(P<0.05).Conclusion：Epidural anesthesia has relatively less influence on cognitive impairment of elderly orthopedic patients and can effectively reduce the risk of cognitive impairment，which is worthy of clinical promotion.
【Key words】 General anesthesia; Epidural anesthesia; Elderly orthopedic patients; Postoperative short-term cognition; Incidence of cognitive impairment; Anesthetic effect
First-author’s address：Yingcheng People’s Hospital，Yingcheng 432400，China
术后短期认知功能障碍是老年患者在接受骨科手术后，出现的短暂中枢神经系统功能异常的症状，也是一种较为常见的术后并发症，患者会出现记忆力减退、精神萎靡及负性情绪等表现。相对于年轻患者而言，老年患者机体恢复能力较弱，手术后发生认知障碍的概率更高，针对此现象，必须选择一种合适的麻醉方式，以降低患者发生认知功能障碍的风险[1-3]。在患者接受骨科手术时需要进行麻醉，麻醉方式可选择硬膜外麻醉、全身麻醉等[4-5]。为了探究硬膜外麻醉、全身麻醉对老年骨科患者术后短期认知功能的影响，采用双色球分组法将纳入研究的134例患者均分为两组，对照组接受全身麻醉，观察组接受硬膜外麻醉，将本次研究结果报道如下。
1 资料与方法
1.1 一般资料
选取2017年2月-2018年2月入院接受治疗的134例老年骨科患者。纳入标准：(1)均为老年骨科手术患者;(2)精神状况、语言表达、沟通能力、理解能力尚可。排除标准：(1)患有严重且需要临床干预的心脏疾病、肝肾疾病、重要器官衰竭等;(2)患有活动性传染疾病;(3)同时患有两种原发癌;(4)依从性较差;(5)不愿参与研究。采用双色球分组法将患者分为对照组与观察组，每组67例。对照组男41例，女26例;年龄62～84岁，平均(70.74±2.94)岁。观察组男35例，女32例;年龄60～85岁，平均(70.34±2.86)岁。笔者将两组一般资料使用统计学软件进行分析，差异均无统计学意义(P>0.05)。本次研究获得医学伦理会的支持，患者对研究内容知情，经笔者回答患者与家属疑问后，均自愿签署知情同意书。, http://www.100md.com(汪伟 张雪莲)