摘要
目的比较七氟醚静吸复合麻醉与全凭静脉麻醉对高龄病人髋关节置换手术后早期认知功能的影响。方法股骨颈骨折病人80例,将80例病人随机分为七氟醚静吸复合麻醉组(A组)和全凭静脉麻醉组(B组),每组各40例。比较两组病人麻醉前后认知功能评分、术后认知功能障碍(POCD)发生率及术后恢复情况。结果 A组术后2小时、6小时简易精神状态检测法(MMSE)评分分别为23.08±2.10、24.86±1.51,B组分别为21.34±1.61和22.12±1.56,两组比较差异有统计学意义(P<0.05);A组术后POCD发生率为20.0%,B组为32.5%,两组比较差异有统计学意义(P<0.05);A组术后2小时、6小时、1天MoCA评分分别为23.88±1.32、24.56±0.88和26.12±1.03,B组分别为21.78±0.88、22.98±1.21和24.48±1.13,两组比较差异有统计学意义(P<0.05)。结论老年髋关节置换病人应用七氟醚静吸复合麻醉比全凭静脉麻醉更有利于减少病人早期POCD的发生,可改善病人术后认知功能。
Objective To compare the early cognitive function of elderly patients underwent sevoflurane static inhalation combined anesthesia and total intravenous anesthesia after total hip replacement.Methods A total of 80 cases with femoral neck fractures were randomly divided into two groups with 40 cases in each group.The A group was given sevoflurane static inhalation combined anesthesia and the B group was given total intravenous anesthesia.The cognitive function score of patients before and after anesthesia,the incidence of postoperative cognitive dysfunction（POCD）and the postoperative recovery were recorded and analyzed.Results The mini-mental state examination（MMSE）score at 2 h（23.08±2.10）and 6 h（24.86±1.51）after surgery in the A group were significantly higher than that at 2 h（21.34±1.61）and 6 h（22.12±1.56）in the B group.There were significant differences between the two groups（P〈0.05）.The incidence of POCD in the A group（20.0%）was significantly lower than that in the B group（32.5%）.There were significant differences between the two groups（P〈0.05）.The MoCA score at 2 h（23.88±1.32）,6 h（24.56±0.88）and 1 d（26.12±1.03）after surgery in the A group were significantly higher than that at 2 h（21.78±0.88）,6 h（22.98±1.21）and 1 d（24.48±1.13）in the B group.There were significant differences between the two groups（P〈0.05）.Conclusion The application of sevoflurane static inhalation combined anesthesia can decrease the incidence of early POCD and effectively improve the cognitive ability of elderly patients after total hip replacement.
出处
《临床外科杂志》
2018年第2期142-144,共3页
Journal of Clinical Surgery
关键词
七氟醚
静吸复合麻醉
全凭静脉麻醉
认知功能
髋关节置换术
sevoflurane static inhalation combined anesthesia
total intravenous anesthesia
total hip replacement
cognitive function
