Objective To evaluate the effects of acute hypervolemic hemodilution combined with controlled hypotension on postoperative cognitive function in elderly patients. Methods A total of 50 patients who underwent elective orthopedic surgery were randomly divided into 2 groups (n =25 each group). The patients in group A received acute hypervolemic hemodilution combined with controlled hypotension,with mean arterial pressure being 65 to 70 mmHg. The patients in group B were control subjects. Mini-mental state examination(MMSE) was used to evaluate the neurological function on preoperative day 1 and postoperative day 3. The serum levels of s100β were meastured at 3 time points,before induction of anesthesia,at the end of operation,and at 6 to 8 hours after operation. Results There was no significant difference in MMSE score and serum level of s100β between 2 groups. Conlusion Acute hypervolemic hemodilution combined with controlled hypotension dose not increase the incidence of postoperative cognitive function in elderly patients.%目的 探讨急性高血容量性血液稀释联合控制性降压对老年患者术后认知功能的影响.方法 选择骨科择期手术患者50例,随机分为A、B两组,每组25例.麻醉诱导后,A组行血液稀释联合控制性降压,调节平均动脉压于60～75 mmHg之间;B组为对照组.分别于术前1 d和术后3 d利用简易智能量表对患者进行神经功能评分;于麻醉诱导前、手术结束、术后6～8 h 3个时点采静脉血1 ml,测量血清中s10013蛋白的含量,评价术后认知功能的发生.结果 两组术后MMSE评分及血清s100β蛋白含量无明显差异.结论 血液稀释联合控制性降压不增加老年患者术后认知功能障碍的发生.
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