论文部分内容阅读
目的：探讨腰－硬联合麻醉和全身麻醉对老年腔隙性梗死患者术后短期认知功能的影响。方法选择2012年6月至2013年12月我院收治的择期行下腹部手术的老年腔隙性梗死患者50例作为研究对象，随机分为腰－硬联合麻醉组（联麻组）和全身麻醉组（全麻组），对比观察2组患者术后认知功能障碍的发生率，采用简易智能状态检测法（MMSE）评分和蒙特利尔认知估量表（MoCA）评分检测2组患者麻醉前及手术后的认知功能。结果联麻组和全麻组术后认知功能障碍（POCD）的发生率分别为12％和32％，2组比较差异有统计学意义（P ＜0．05）；术后各时间点 MMSE 评分及 MoCA 评分均低于麻醉前，差异具有统计学意义（P ＜0．05）；联麻组患者 MMSE 评分及 MoCA 评分在术后3 h 和6 h 均高于全麻组，差异具有统计学意义（P ＜0．05）。结论手术麻醉对老年腔隙性梗死患者会造成一定程度的认知功能障碍，使用腰-硬联合麻醉相对于全身麻醉可降低该类患者认识功能障碍的发生率。“,”Objective To investigate the influence of combined spinal-epidural anesthesia and general anesthesia on short-term cogni-tive function of elderly patients with lacunar infarction after surgery.Methods A total of 50 patients with lacunar infarction who underwent abdominal surgery in our hospital from June 2012 to December 2013 were selected as the research object,who were divided into spinal-epi-dural anesthesia group (combined group)and general anesthesia group (general group).The incidence of postoperative cognitive dysfunction of two groups were observed and compared.The mini-mental state examination(MMSE)and Montreal cognitive Assessment(MoCA)were used to evaluated the cognitive function before and postoperative 1 day.Results The probability of postoperative cognitive dysfunction (POCD)of combined group and the general group were 12% and 32%,respectively,and the POCD probability of combined group was lower than that of general group,the difference was significant(P <0.05).The MMSE score and MoCA score at postoperative 1 day of two groups were lower than those before anesthesia,the difference was significant(P <0.05).The MMSE score and MoCA score of combined group at postoperative 1 day were lower than that of general group,the difference was significant(P <0.05).Conclusion The anesthesia can cause a certain cognitive dysfunction for elderly patients with lacunar infarction,while the spinal-epidural anesthesia can reduce the incidence rate of POCD compared anesthesia.