下肢神经阻滞复合喉罩全身麻醉对老年单膝关节置换术患者术后认知功能的影响

发布时间：2018-01-18 00:20

本文关键词：下肢神经阻滞复合喉罩全身麻醉对老年单膝关节置换术患者术后认知功能的影响　出处：《中国民康医学》2016年07期 　论文类型：期刊论文

【摘要】：目的:研究下肢神经阻滞复合喉罩全身麻醉法对老年单膝关节置换术患者术后认知功能的影响。方法:将86例择期行单膝关节置换术的老年患者随机分为观察组和对照组,每组各43例。观察组患者采用下肢神经阻滞复合喉罩全身麻醉法;对照组患者采用气管插管全身麻醉法。对比两组患者围手术期平均动脉压(MAP)和简易精神状态量表(MMSE)评分。结果:在麻醉前(T0)及术后6 h(T5)两个时间点上,两组患者的MAP值无明显差异(P0.05);观察组患者的MAP值在置入喉罩或气管插管成功后1 min(T1)、使用止血带60 min(T2)及拔出喉罩或气管导管后1 min(T4)均明显低于对照组(P0.01),而在松开止血带5 min(T3)明显高于对照组(P0.01);在术后6 h及术后12 h,观察组患者的MMSE分值均明显高于对照组(P0.01);观察组的POCD发生率为9.30%,对照组为25.58%,观察组患者的POCD发生率低于对照组(P0.05)。结论:在老年单膝关节置换术患者中采用下肢神经阻滞复合喉罩全身麻醉,相较于气管插管全身麻醉对其围手术期生理指标影响更小,同时对术后认知功能影响更小,有助于降低患者术后POCD发生。
[Abstract]:Objective: to study the effect of lower limb nerve block combined with laryngeal mask general anesthesia on cognitive function of elderly patients undergoing single knee arthroplasty. 86 elderly patients undergoing single knee arthroplasty were randomly divided into observation group and control group. There were 43 cases in each group. The patients in the observation group were treated with lower limb nerve block combined with laryngeal mask general anesthesia. The patients in the control group were treated with tracheal intubation general anesthesia. The mean arterial pressure (MAP) and MMSE scores were compared between the two groups. Results: before anesthesia, T0). And 6 h after operation. There was no significant difference in MAP between the two groups (P 0.05). The MAP value of the patients in the observation group was 1 min after the laryngeal mask or tracheal intubation was successfully inserted. The level of T4 was significantly lower than that of the control group (P 0.01) after 60 mins of tourniquet and 1 min after pulling out the laryngeal mask or trachea catheter. The level of T3 at 5 min after release of tourniquet was significantly higher than that of control group (P 0.01). The MMSE scores of the patients in the observation group were significantly higher than those in the control group at 6 hours and 12 hours after operation. The incidence of POCD was 9.30 in the observation group and 25.58% in the control group. The incidence of POCD in the observation group was lower than that in the control group (P 0.05). Conclusion: the lower extremity nerve block combined with laryngeal mask general anesthesia is used in the elderly patients undergoing single knee arthroplasty. Compared with tracheal intubation, general anesthesia has less effect on perioperative physiological index and cognitive function, which is helpful to reduce the incidence of postoperative POCD.
【作者单位】：新疆医科大学第五附属医院麻醉科;
【分类号】：R614
【正文快照】： 对于患有膝关节骨性关节或退行性骨关节病等膝关节疾病患者,通过手术行人工膝关节置换可取得良好的效果。但由于老年患者心肺储备功能较差以及脊椎退行性改变,使得传统人工膝关节置换术中实施的椎管内麻醉方式使用受限[1]。同时研究[2]认为麻醉方式对术后认知障碍(POCD)患者的

【相似文献】