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时间:2020-05-02
《不同麻醉方法对老年患者术后认知功能的影响.pdf》由会员上传分享,免费在线阅读,更多相关内容在行业资料-天天文库。
1、实用临床医学2014年第15卷第3期Prac~calClinicalMedicine,2014.Vol15.No3·49·不同麻醉方法对老年患者术后认知功能的影响代华锋(柘城县中医院麻醉科,河南柘城476200)摘要:目的探讨不同麻醉方法对老年患者术后认知功能的影响。方法将110例拟行手术的老年患者按麻醉方法的不同分为2组:观察组和对照组,每组55例。观察组行硬脊膜外阻滞麻醉,对照组行全身麻醉。观察2组异丙酚、芬太尼使用量、术后疾病恢复时间及术后认知功能障碍发生的情况,并对2组麻醉前及术后6、24和72h采用简易精神状态量表(
2、MMSE)进行认知功能评分。结果与对照组比较,观察组术后6、24和72hMMSE得分、异丙酚使用量均明显升高(均P<0.05),芬太尼使用量、术后认知功能障碍发生率均明显降低和术后疾病恢复时间明显缩短(均P3、3EffectsofDifferentAnesthesiaMethodsonPostoperativeCognitiveFunctioninElderlyPatientsDAIHua-feng(DepartmentofAnesthesiology,ZhechengCountyHospitalofTraditionalChineseMedicine,Zhecheng476200,China)ABSTRACT:ObjectiveToinvestigatetheeffectsofdifferentanesthesiamethodso4、npostoperativecognitivefunctioninelderlypatients.MethodsAtotalof110elderlypatientsscheduledforsurgerywereassignedtoreceiveeitherepiduralanaesthesia(observationgroup,n=55)orgeneralanesthesia(controlgroup,n=55).Thedosesofpropofolandfentanyl,postoperativerecoverytimean5、dincidenceofpostoperativecognitivedysfunctionwereobservedinbothgroups.PostoperativecognitivefunctionwasevaluatedusingtheMini-MentalStateExamination(MMSE)beforeanesthesiaand6,24and72hoursafteroperation.ResultsComparedwithcontrolgroup,epiduralanaesthesiaincreasedMMSEs6、coreandpropofoldose,decreasedfentanyldoseandincidenceofpostoperativecognitivedysfunction,andshortenedpostoperativerecoverytime6,24and72hoursafteroperation(P<0.05).ConclusionEpiduralanaesthesiaexertsmildereffectandresultsinlowerincidenceofpostoperativecognitivedysfun7、ctionthangeneralanesthesia.Furthermore,epiduralanaesthesiadoesnotincreasethedoseofanaesthetic.Therefore,epiduralanaesthesiaistheoptimalchoiceforelderlypatients.KEYWORDS:elderlypatients;postoperativecognitivedysfunction;epiduralanaesthesia;generalanesthesia术后认知功能障碍是指8、手术麻醉后数天内发示,术后认知功能障碍常常是由高龄、酗酒、营养不生的一种可逆的、具有波动性的急性精神紊乱综合良及心理因素等易发因素和手术创伤、低血压、术征,临床表现为认知能力异常、精神错乱、人格的改中出血及输血等促发因素引起的[23。术后认知功能变、焦虑或抑郁以及记忆受损[1
3、3EffectsofDifferentAnesthesiaMethodsonPostoperativeCognitiveFunctioninElderlyPatientsDAIHua-feng(DepartmentofAnesthesiology,ZhechengCountyHospitalofTraditionalChineseMedicine,Zhecheng476200,China)ABSTRACT:ObjectiveToinvestigatetheeffectsofdifferentanesthesiamethodso
4、npostoperativecognitivefunctioninelderlypatients.MethodsAtotalof110elderlypatientsscheduledforsurgerywereassignedtoreceiveeitherepiduralanaesthesia(observationgroup,n=55)orgeneralanesthesia(controlgroup,n=55).Thedosesofpropofolandfentanyl,postoperativerecoverytimean
5、dincidenceofpostoperativecognitivedysfunctionwereobservedinbothgroups.PostoperativecognitivefunctionwasevaluatedusingtheMini-MentalStateExamination(MMSE)beforeanesthesiaand6,24and72hoursafteroperation.ResultsComparedwithcontrolgroup,epiduralanaesthesiaincreasedMMSEs
6、coreandpropofoldose,decreasedfentanyldoseandincidenceofpostoperativecognitivedysfunction,andshortenedpostoperativerecoverytime6,24and72hoursafteroperation(P<0.05).ConclusionEpiduralanaesthesiaexertsmildereffectandresultsinlowerincidenceofpostoperativecognitivedysfun
7、ctionthangeneralanesthesia.Furthermore,epiduralanaesthesiadoesnotincreasethedoseofanaesthetic.Therefore,epiduralanaesthesiaistheoptimalchoiceforelderlypatients.KEYWORDS:elderlypatients;postoperativecognitivedysfunction;epiduralanaesthesia;generalanesthesia术后认知功能障碍是指
8、手术麻醉后数天内发示,术后认知功能障碍常常是由高龄、酗酒、营养不生的一种可逆的、具有波动性的急性精神紊乱综合良及心理因素等易发因素和手术创伤、低血压、术征,临床表现为认知能力异常、精神错乱、人格的改中出血及输血等促发因素引起的[23。术后认知功能变、焦虑或抑郁以及记忆受损[1
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