不同麻醉方法对老年患者术后认知功能的影响

目的探讨不同麻醉方法对老年患者术后认知功能的影响。方法96例患者随机分为观察组和对照组．前者采用硬膜外麻醉，后者采用全身麻醉，对比两组患者麻醉前和术后6h、24h及72h的MMSE评分、POCD发生率、麻醉药用量、术后疾病恢复时间。结果MMSE评分两组术后均较麻醉前降低，各组前后比较均有统计学意义（P〈0．01）；而术后各时段观察组均高于对照组，差异有统计学意义（P〈0．01），POCD发生率观察组明显低于对照组．疾病恢复时间短于对照组，差异有高度统计学意义（P〈0．01）；两组麻醉药用量比较差异无统计学意义（P〉0．05）。结论硬膜外麻醉对老年患者术后认知功能影响轻，POCD发生率低，疾病恢复快。且不增加麻醉药量．值得选用。

The effect of different anesthesia methods for the postoperative cognitive function in the elderly patients

Objective To explore different anesthesia for postoperative cognitive function in the elderly patients.Methods All 96 elderly patients were randomly divided into observation group and control group,the observation group was given epidural anesthesia while the control group was received general anesthesia.The MMSE scores,incidences of POCD,the amount of anesthetic and recovery time were compared before the anesthetic,after 6 h,24 h and 72 h of the surgery.Results After the surgery,MMSE scores were lower both of the two groups,and there was significant difference before and after the surgery(P < 0.01),the observation group was higher than the control group after the surgery(P < 0.01);The incidences of POCD in the observation group were lower than the control group and the recovery time was also shorter than the control group(P < 0.01);There was no significant difference in the amount of anesthetic between the two groups(P > 0.05).Conclusion Epidural anesthesia has mild impact on postoperative cognitive function in elderly patients,the incidence of POCD is low and the recovery time is rapid,and it is no need for increasing the amount of anesthetic;it is worth to be applied in clinical.