摘要
目的分析腰-硬联合麻醉、全身麻醉对下肢骨折手术老年患者认知功能与循环功能的影响。方法将100例下肢骨折的老年患者分为全麻组和腰-硬联合组,每组50例。全麻组给予全身麻醉,腰-硬联合组给予腰-硬联合麻醉。比较2组麻醉前后的血流动力学、患者认知功能的变化。结果腰-硬联合组麻醉后12、24 h的简易精神状态量表(MMSE)评分高于全麻组,差异有统计学意义(P<0.05);腰-硬联合组T4、T5时谵妄诊断用量表(CAM)评分低于全麻组,差异有统计学意义(P<0.05);2组T2、T3时平均动脉压相比差异有统计学意义(P<0.05);2组在T2、T3时心率相比差异有统计学意义(P<0.05)。结论老年患者选择腰-硬联合麻醉,可以减少对中枢神经功能的损伤,进而避免引起患者认知功能异常。
Objective To analyze the effect of combined spinal-epidural anesthesia and general anesthesia on the cognitive function and circulatory function of elderly patients undergoing lower extremity fracture surgery.Methods A total of 100 elderly patients with lower extremity fractures were divided into two groups,with 50 cases in each group The general anesthesia group was given general anesthesia,and the combined spinal-epidural anesthesia group was given combined spinal-epidural anesthesia.The hemodynamics before and after anesthesia and the cognitive function of patients were compared between the two groups.Results The Mini-Mental State Examination(MMSE)scores of the combined spinal-epidural anesthesia group at 12 and 24 hours after anesthesia were significantly higher than those in the general anesthesia group(P<0.05);the Confusion Assessment Method(CAM)scores of the combined spinal-epidural anesthesia group at T4 and T5 were significantly lower than those in the general anesthesia group(P<0.05).There were significant differences in average arterial pressure at T2 and T3 of the two groups(P<0.05).There were significant differences in heart rate at T2 and T3 in two groups(P<0.05).Conclusion Combined spinal-epidural anesthesia reduce the damage to the central nervous function and avoid the cognitive dysfunction of elderly patients.
作者
樊航行
张大志
段崇珍
FAN Hangxing;ZHANG Dazhi;DUAN Chongzhen(Department of Anesthesiology,Tongchuan City People's Hospital,Tongchuan,Shaanxi,727000;The First Surgery Department of Anesthesiology,Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine,Xianyang,Shaanxi,712000)
出处
《实用临床医药杂志》
CAS
2020年第16期82-84,共3页
Journal of Clinical Medicine in Practice
关键词
全身麻醉
腰-硬联合麻醉
循环功能
认知功能
general anesthesia
combined spinal-epidural anesthesia
circulatory function
cognitive function
