不同麻醉方法对老年患者术后早期认知功能的影响

发布时间：2018-04-16 18:44

  本文选题：全身麻醉 + 局部麻醉　； 参考：《临床医药实践》2016年08期

【摘要】：目的:研究老年患者实施不同的麻醉方法手术对早期认知功能产生的影响。方法:选择2013年5月—2015年5月诊治的120例老年手术患者,根据手术采取麻醉方法的不同分为三组,每组40例。A组实施局部麻醉;B组实施硬膜外麻醉;C组实施全身麻醉。分别在术前及术后的1,3,5 d对其认知功能进行评定,同时运用Logistic分析可能对老年患者术后认知功能产生影响的因素。结果:通过比较,C组患者术后1,3,5 d的简易智力状况检查(MMSE)评分明显比其他两组低,差异有统计学意义(P0.05)。但是C组与A组和B组相比,术后出现认知功能障碍的概率比较差异无统计学意义(P0.05)。运用单因素分析,对老年患者认知功能产生影响的因素主要有患者年龄、手术时间、术前MMSE评分等,通过多因素非条件Logistic回归分析能够看出,年龄属于一个独立的危险因素。结论:老年患者手术操作实施全身麻醉对其认知功能影响明显,但是老年患者实施不同麻醉方法对其早期出现认知功能障碍未见明显差异,老年患者术后早期出现认知功能障碍的一个明显影响的因素是年龄。
[Abstract]:Objective: to study the effect of different anesthesia methods on early cognitive function in elderly patients.Methods: 120 elderly patients who were diagnosed and treated from May 2013 to May 2015 were divided into three groups according to different anesthetic methods. Each group (40 cases) was treated with local anesthesia. Group B was given epidural anesthesia and group C was given general anesthesia.The cognitive function was evaluated before and 5 days after operation, and the factors that might affect the cognitive function of the elderly patients were analyzed by Logistic analysis.Results: the MMSE score of group C was significantly lower than that of the other two groups (P 0.05).However, there was no significant difference between group C and group A and B in the incidence of cognitive dysfunction after operation (P 0.05).Using univariate analysis, the main factors influencing the cognitive function of elderly patients were age, operation time, preoperative MMSE score and so on. Through multivariate conditional Logistic regression analysis, we can see that age belongs to an independent risk factor.Conclusion: the effect of general anesthesia on the cognitive function of elderly patients is obvious, but there is no significant difference in the early occurrence of cognitive dysfunction in elderly patients with different anesthetic methods.Age is a significant factor affecting cognitive impairment in elderly patients early after surgery.
【作者单位】： 太原市人民医院;
【分类号】：R614
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本文编号：1760141