目的 比较全身麻醉和腰硬联合麻醉对老年骨科患者术后短期认知功能的影响.方法 60例行手术治疗的老年骨科患者随机分为全麻组和腰硬联合麻醉组.比较2组患者麻醉效果及术后短期认知功能情况.结果 诱导麻醉前及麻醉后6、12、72 h,2组患者认知功能评分对比均无显著差异(P＞0.05).麻醉后24 h,全身麻醉组患者认知功能评分显著低于腰硬联合麻醉组(P＜0.05).2组术后心率和神经精神异常发生率比较无显著差异(P＞0.05).结论 全身麻醉容易出现认知功能障碍,建议优先使用腰硬联合麻醉.%Objective To compare the effect of general anesthesia and combined spinal-epidural anesthesia on short-term cognitive function in the elderly patients in the department of orthopedics.Methods Totally 60 elderly patients in the department of orthopedics were randomly divided into the general anesthesia group and the combined spinal-epidural group.The effect of anesthesia and the short-term cognitive function after operation were compared between the two groups.Results Before anesthesia induction and 6,12,72 h after anesthesia,there was no significant difference in the score of cognitive function between the two groups (P ＞ 0.05).24 h after anesthesia,the score of cognitive function in the general anesthesia group was significantly lower than that in the combined spinal-epidural anesthesia group (P ＜ 0.05).There was no significant difference in the postoperative heart rate and neuropsychosis between the two groups (P ＞ 0.05).Conclusion General anesthesia is easy to cause cognitive impairment,so it is recommended to give priority to combined spinal-epidural anesthesia.
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