麻醉方式对老年膝关节置换术患者术后认知功能影响

发布时间：2018-01-18 05:32

本文关键词：麻醉方式对老年膝关节置换术患者术后认知功能影响　出处：《浙江创伤外科》2016年02期 　论文类型：期刊论文

【摘要】：目的观察麻醉方式对老年膝关节置换术患者术后认识功能的影响,为临床麻醉提供参考。方法选取本院收治老年膝关节置换术患者150例为研究对象,随机分为观察组和对照组,对照组全麻,观察组腰硬联合麻醉。观察患者认知功能变化,并比较患者各指标变化。结果术后1天和术后5天,观察组患者MMSE评分均显著高于对照组,P0.05。术后1天,观察组患者PDCD发生率显著低于对照组,P0.05;术后5天,观察组患者PDCD发生率低于对照组,但差异不明显,P0.05。观察组和对照组T1时刻和T3时刻Tau蛋白血清浓度无明显差异,P0.05;T2时刻,观察组Tau蛋白血清浓度显著低于对照组,P0.05。POCD组和非POCD组T1时刻和T3时刻Tau蛋白无明显差异,P0.05;T2时刻,POCD组Tau蛋白血清浓度显著高于非POCD组,P0.05。结论老年膝关节置换术患者治疗中,采用腰硬联合麻醉方式能够提高认知功能,减少POCD发生率,Tau蛋白浓度升高可能会引起POCD的发生。
[Abstract]:Objective to observe the effect of anaesthesia on the cognitive function of elderly patients undergoing knee arthroplasty, and to provide reference for clinical anesthesia. Methods 150 cases of senile knee arthroplasty in our hospital were selected as the research objects. They were randomly divided into observation group and control group, general anesthesia in control group, combined spinal-epidural anesthesia in observation group. The changes of cognitive function were observed, and the indexes of patients were compared. Results 1 day after operation and 5 days after operation. The MMSE scores in the observation group were significantly higher than those in the control group (P 0.05). The incidence of PDCD in the observation group was significantly lower than that in the control group 1 day after operation (P 0.05). 5 days after operation, the incidence of PDCD in the observation group was lower than that in the control group, but the difference was not significant (P 0.05). There was no significant difference in the serum concentration of Tau protein between the observation group and the control group at T1 and T3. P0.05; At T2 time, the serum concentration of Tau protein in the observation group was significantly lower than that in the control group P0.05.POCD group and non-#en1# group. There was no significant difference in Tau protein between the control group and non-#en1# group at T1 and T3 time. The serum concentration of Tau protein was significantly higher in POCD group than that in non-#en1# group at T2 moment (P 0.05). Conclusion in the elderly patients with knee arthroplasty, the serum concentration of Tau protein is significantly higher than that in the control group. Combined spinal-epidural anesthesia can improve cognitive function and reduce the incidence of POCD. The increase of Tau protein concentration may lead to the occurrence of POCD.
【作者单位】：温州医科大学附属第三医院;温州医科大学附属第一医院;
【分类号】：R614
【正文快照】： 术后认知功能障是指术前无精神异常而术后出现大脑功能紊乱的情况,包括认知、定量、精神等方面的异常。很多研究[1,2]发现老年膝关节置换术术后患者认知功能障碍(POCD)发病率很高,存在多种影响因素。有研究发现,不同麻醉方式对POCD的影响不同,其中全麻患者术后认知功能障碍发

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