Selection of anesthesia mode for elderly patients with lower extremity fracture undergoing surgery
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摘要: 目的 分析腰-硬联合麻醉、全身麻醉对下肢骨折手术老年患者认知功能与循环功能的影响。 方法 将100例下肢骨折的老年患者分为全麻组和腰-硬联合组,每组50例。全麻组给予全身麻醉,腰-硬联合组给予腰-硬联合麻醉。比较2组麻醉前后的血流动力学、患者认知功能的变化。 结果 腰-硬联合组麻醉后12、24 h的简易精神状态量表(MMSE)评分高于全麻组,差异有统计学意义(P<0.05); 腰-硬联合组T4、T5时谵妄诊断用量表(CAM)评分低于全麻组,差异有统计学意义(P<0.05); 2组T2、T3时平均动脉压相比差异有统计学意义(P<0.05); 2组在T2、T3时心率相比差异有统计学意义(P<0.05)。 结论 老年患者选择腰-硬联合麻醉,可以减少对中枢神经功能的损伤,进而避免引起患者认知功能异常。Abstract: Objective To analyze the effect of combined spinal-epidural anesthesia and general anesthesia on the cognitive function and circulatory function of elderly patients undergoing lower extremity fracture surgery. Methods A total of 100 elderly patients with lower extremity fractures were divided into two groups, with 50 cases in each group The general anesthesia group was given general anesthesia, and the combined spinal-epidural anesthesia group was given combined spinal-epidural anesthesia. The hemodynamics before and after anesthesia and the cognitive function of patients were compared between the two groups. Results The Mini-Mental State Examination(MMSE)scores of the combined spinal-epidural anesthesia group at 12 and 24 hours after anesthesia were significantly higher than those in the general anesthesia group(P<0.05); the Confusion Assessment Method(CAM)scores of the combined spinal-epidural anesthesia group at T4 and T5 were significantly lower than those in the general anesthesia group(P<0.05). There were significant differences in average arterial pressure at T2 and T3 of the two groups(P<0.05). There were significant differences in heart rate at T2 and T3 in two groups(P<0.05). Conclusion Combined spinal-epidural anesthesia reduce the damage to the central nervous function and avoid the cognitive dysfunction of elderly patients.
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余育斌, 方韬, 叶志坚. 全身麻醉和硬膜外麻醉对老年骨科患者术后短期认知功能影响的临床分析[J]. 中国农村卫生事业管理, 2017, 37(11): 1411-1413. 焦晓红, 杨丹锋, 宋国军, 等. 全身麻醉与腰-硬联合麻醉对老年患者下肢骨折手术后认知功能的影响[J]. 实用临床医药杂志, 2019, 23(11): 79-82. 张百军, 杨赵栋, 郑旻, 等. 硬膜外麻醉和全身麻醉对老年骨科患者术后认知功能影响比较[J]. 浙江医学, 2015, 37(7): 595-596. 李晓艳. 右美托咪定对老年患者全麻诱导期间心率变异性及术后躁动和认知功能的影响[J]. 医学临床研究, 2017, 34(12): 2373-2375. 高文蔚, 陈榕, 刘恋, 等. 右美托咪定对老年患者全麻术后认知功能障碍的Meta分析[J]. 海南医学, 2016, 27(14): 2379-2382. 沈雷兵, 周新华, 沈伯雄. 术中保温对老年病人全麻苏醒时间及苏醒期丙泊酚效应室浓度的影响[J]. 安徽医药, 2017, 21(6): 1045-1048. 王琳, 罗宇, 钱家树, 等. 不同麻醉方法对单侧下肢骨关节手术围手术期凝血功能的影响[J]. 中华全科医学, 2017, 15(12): 2065-2067 , 2140.
黄文新, 叶春芳, 冯杜浒, 等. 超声引导股神经-股外侧皮神经阻滞联合喉罩全麻在股骨干骨折手术的应用效果[J]. 安徽医学, 2019, 40(2): 141-144. 童华, 王庭辉, 王欣路, 等. 右美托咪定联合舒芬太尼对老年下肢骨折手术患者全麻苏醒期血流动力学及应激状态的影响[J]. 海南医学院学报, 2019, 25(13): 1021-1025. 陈新凯, 郑焕金, 陈少霞. 全身麻醉复合不同剂量右美托咪定持续输注对老年髋部骨折患者的影响[J]. 中华老年多器官疾病杂志, 2019, 18(9): 674-677. 陈勇, 宋直雷, 范军朝, 等. 维持剂量右美托咪定对行妇科手术的全麻老年患者术后认知功能的影响[J]. 安徽医药, 2017, 21(11): 2052-2056. 陈吕富, 余云明, 高德胜, 等. 不同麻醉药物配伍对行腹腔镜下肿瘤切除手术的老年患者血流动力学及术后认知功能的影响[J]. 实用癌症杂志, 2017(2): 320-323. 郭向阳. 老年患者骨科手术麻醉管理的临床热点[J]. 中华麻醉学杂志, 2018, 8(7): 778-784. 汪云飞, 张帝, 周明星, 等. 盐酸右美托咪定用于老年患者膝关节镜手术腰麻联合硬膜外麻醉的临床观察[J]. 安徽医药, 2016, 20(6): 1194-1196. 肖剑, 罗星燎, 李文昌, 等. 不同浓度右美托咪定对全身麻醉下胸腰椎体手术老年患者免疫与认知功能障碍的影响[J]. 检验医学与临床, 2016, 13(6): 775-778. 高友光, 林献忠, 林财珠, 等. 不同麻醉方法下老年患者术后认知功能障碍发生的比较[J]. 中华麻醉学杂志, 2016, 36(11): 1337-1340.
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