本文關(guān)鍵詞：下肢神經(jīng)阻滯復(fù)合喉罩全身麻醉對(duì)老年單膝關(guān)節(jié)置換術(shù)患者術(shù)后認(rèn)知功能的影響　出處：《中國(guó)民康醫(yī)學(xué)》2016年07期 　論文類型：期刊論文

  更多相關(guān)文章： 下肢神經(jīng)阻滯 氣管插管 術(shù)后認(rèn)知功能障礙

【摘要】：目的:研究下肢神經(jīng)阻滯復(fù)合喉罩全身麻醉法對(duì)老年單膝關(guān)節(jié)置換術(shù)患者術(shù)后認(rèn)知功能的影響。方法:將86例擇期行單膝關(guān)節(jié)置換術(shù)的老年患者隨機(jī)分為觀察組和對(duì)照組,每組各43例。觀察組患者采用下肢神經(jīng)阻滯復(fù)合喉罩全身麻醉法;對(duì)照組患者采用氣管插管全身麻醉法。對(duì)比兩組患者圍手術(shù)期平均動(dòng)脈壓(MAP)和簡(jiǎn)易精神狀態(tài)量表(MMSE)評(píng)分。結(jié)果:在麻醉前(T0)及術(shù)后6 h(T5)兩個(gè)時(shí)間點(diǎn)上,兩組患者的MAP值無(wú)明顯差異(P0.05);觀察組患者的MAP值在置入喉罩或氣管插管成功后1 min(T1)、使用止血帶60 min(T2)及拔出喉罩或氣管導(dǎo)管后1 min(T4)均明顯低于對(duì)照組(P0.01),而在松開(kāi)止血帶5 min(T3)明顯高于對(duì)照組(P0.01);在術(shù)后6 h及術(shù)后12 h,觀察組患者的MMSE分值均明顯高于對(duì)照組(P0.01);觀察組的POCD發(fā)生率為9.30%,對(duì)照組為25.58%,觀察組患者的POCD發(fā)生率低于對(duì)照組(P0.05)。結(jié)論:在老年單膝關(guān)節(jié)置換術(shù)患者中采用下肢神經(jīng)阻滯復(fù)合喉罩全身麻醉,相較于氣管插管全身麻醉對(duì)其圍手術(shù)期生理指標(biāo)影響更小,同時(shí)對(duì)術(shù)后認(rèn)知功能影響更小,有助于降低患者術(shù)后POCD發(fā)生。
[Abstract]:Objective: to study the effect of lower limb nerve block combined with laryngeal mask general anesthesia on cognitive function of elderly patients undergoing single knee arthroplasty. 86 elderly patients undergoing single knee arthroplasty were randomly divided into observation group and control group. There were 43 cases in each group. The patients in the observation group were treated with lower limb nerve block combined with laryngeal mask general anesthesia. The patients in the control group were treated with tracheal intubation general anesthesia. The mean arterial pressure (MAP) and MMSE scores were compared between the two groups. Results: before anesthesia, T0). And 6 h after operation. There was no significant difference in MAP between the two groups (P 0.05). The MAP value of the patients in the observation group was 1 min after the laryngeal mask or tracheal intubation was successfully inserted. The level of T4 was significantly lower than that of the control group (P 0.01) after 60 mins of tourniquet and 1 min after pulling out the laryngeal mask or trachea catheter. The level of T3 at 5 min after release of tourniquet was significantly higher than that of control group (P 0.01). The MMSE scores of the patients in the observation group were significantly higher than those in the control group at 6 hours and 12 hours after operation. The incidence of POCD was 9.30 in the observation group and 25.58% in the control group. The incidence of POCD in the observation group was lower than that in the control group (P 0.05). Conclusion: the lower extremity nerve block combined with laryngeal mask general anesthesia is used in the elderly patients undergoing single knee arthroplasty. Compared with tracheal intubation, general anesthesia has less effect on perioperative physiological index and cognitive function, which is helpful to reduce the incidence of postoperative POCD.
【作者單位】： 新疆醫(yī)科大學(xué)第五附屬醫(yī)院麻醉科;
【分類號(hào)】：R614
【正文快照】： 對(duì)于患有膝關(guān)節(jié)骨性關(guān)節(jié)或退行性骨關(guān)節(jié)病等膝關(guān)節(jié)疾病患者,通過(guò)手術(shù)行人工膝關(guān)節(jié)置換可取得良好的效果。但由于老年患者心肺儲(chǔ)備功能較差以及脊椎退行性改變,使得傳統(tǒng)人工膝關(guān)節(jié)置換術(shù)中實(shí)施的椎管內(nèi)麻醉方式使用受限[1]。同時(shí)研究[2]認(rèn)為麻醉方式對(duì)術(shù)后認(rèn)知障礙(POCD)患者的

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 張躍軍,葛永進(jìn);選擇性下肢神經(jīng)阻滯在下肢手術(shù)中的應(yīng)用[J];浙江臨床醫(yī)學(xué);2003年04期

2 嚴(yán)相默,李香月,孫玉;直線偏振光近紅外線照射合用神經(jīng)阻滯提高治痛效果的量化評(píng)估[J];中國(guó)臨床康復(fù);2005年26期

3 湯洪;陳何偉;劉志奇;;神經(jīng)阻滯時(shí)機(jī)與老年人發(fā)生帶狀皰疹后神經(jīng)痛關(guān)系的觀察[J];中國(guó)疼痛醫(yī)學(xué)雜志;2007年02期

4 Robert Helfand;劉若杉;郭向陽(yáng);;下肢神經(jīng)阻滯[J];實(shí)用疼痛學(xué)雜志;2007年06期

5 高顯平;;區(qū)域神經(jīng)阻滯治療腹股溝疝62例臨床分析[J];首都醫(yī)藥;2009年02期

6 鄧曉東;駱英;;三種神經(jīng)阻滯在鎖骨骨折手術(shù)的應(yīng)用[J];臨床麻醉學(xué)雜志;2010年08期

7 陳平;顧華華;劉妍s，

本文編號(hào)：1438637