腰丛联合坐骨神经阻滞复合七氟烷对老年髋关节术后患者脑源性神经生长因子及认知功能的影响

发布时间：2018-04-10 22:23

本文选题：腰丛-坐骨神经阻滞 + 七氟烷　；参考：《中国老年学杂志》2015年23期

【摘要】：目的观察腰丛联合坐骨神经阻滞复合七氟烷对老年髋关节术后患者认知功能以及血清脑源性神经生长因子(BDNF)的影响。方法回顾性分析单侧全髋关节置换术患者70例,按照随机数字表法分为对照组和观察组均35例;对照组患者采取常规气管插管全麻,配合采用静脉给予丙泊酚麻醉维持;观察组先进行腰丛及坐骨神经阻滞后行气管插管全麻,配合采取吸入七氟烷麻醉维持;记录两组手术时间、失血量以及不良反应发生情况;比较两组术前、术后1 d和术后3 d患者的简易精神状态量表(MMSE)评分、蒙特利尔认知评估量表(MoCA)评分以及血清BDNF水平;分析血清BDNF水平与MMSE评分和MoCA评分的相关性。结果观察组术后1 d和3 d患者MMSE和Mo CA评分以及血清BDNF水平均明显高于对照组(P0.01);观察组患者血清BDNF水平与MMSE和MoCA均呈正相关(r=0.52、0.49,均P0.01);观察组不良反应发生率明显低于对照组(P0.01)。结论腰丛联合坐骨神经阻滞复合七氟烷可明显提高患者血清BDNF水平,降低老年髋关节患者术后认知障碍的发生。
[Abstract]:Objective to observe the effects of lumbar plexus combined with sciatic nerve block and sevoflurane on cognitive function and serum brain-derived nerve growth factor (BDNF) in elderly patients after hip surgery.Methods 70 cases of unilateral total hip replacement were retrospectively analyzed and divided into control group (n = 35) and observation group (n = 35) according to random digital table, the patients in control group were treated with routine tracheal intubation general anesthesia, combined with intravenous administration of propofol.The observation group was treated with lumbar plexus block and sciatic nerve block, followed by tracheal intubation general anesthesia, combined with sevoflurane inhalation anesthesia to maintain the operation time, blood loss and adverse reactions in the two groups.The scores of mini-mental state scale (MMSE), Montreal Cognitive Assessment scale (MMA) and serum BDNF were evaluated on the 1st and 3rd day after operation, and the correlation between the serum BDNF level and MMSE and MoCA scores were analyzed.Results the scores of MMSE and MoCA and the level of serum BDNF in the observation group were significantly higher than those in the control group on the 1st and 3rd day after operation, the serum BDNF levels in the observation group were positively correlated with MMSE and MoCA, and the incidence of adverse reactions in the observation group was significantly lower than that in the control group (P 0.01).Conclusion Lumbar plexus combined with sciatic nerve block combined with sevoflurane can significantly increase serum BDNF level and reduce cognitive impairment in elderly patients with hip joint.
【作者单位】：青海大学附属医院麻醉科;
【分类号】：R614

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