本文選題：腰叢-坐骨神經(jīng)阻滯 + 七氟烷　； 參考：《中國老年學(xué)雜志》2015年23期

【摘要】：目的觀察腰叢聯(lián)合坐骨神經(jīng)阻滯復(fù)合七氟烷對老年髖關(guān)節(jié)術(shù)后患者認(rèn)知功能以及血清腦源性神經(jīng)生長因子(BDNF)的影響。方法回顧性分析單側(cè)全髖關(guān)節(jié)置換術(shù)患者70例,按照隨機(jī)數(shù)字表法分為對照組和觀察組均35例;對照組患者采取常規(guī)氣管插管全麻,配合采用靜脈給予丙泊酚麻醉維持;觀察組先進(jìn)行腰叢及坐骨神經(jīng)阻滯后行氣管插管全麻,配合采取吸入七氟烷麻醉維持;記錄兩組手術(shù)時間、失血量以及不良反應(yīng)發(fā)生情況;比較兩組術(shù)前、術(shù)后1 d和術(shù)后3 d患者的簡易精神狀態(tài)量表(MMSE)評分、蒙特利爾認(rèn)知評估量表(MoCA)評分以及血清BDNF水平;分析血清BDNF水平與MMSE評分和MoCA評分的相關(guān)性。結(jié)果觀察組術(shù)后1 d和3 d患者M(jìn)MSE和Mo CA評分以及血清BDNF水平均明顯高于對照組(P0.01);觀察組患者血清BDNF水平與MMSE和MoCA均呈正相關(guān)(r=0.52、0.49,均P0.01);觀察組不良反應(yīng)發(fā)生率明顯低于對照組(P0.01)。結(jié)論腰叢聯(lián)合坐骨神經(jīng)阻滯復(fù)合七氟烷可明顯提高患者血清BDNF水平,降低老年髖關(guān)節(jié)患者術(shù)后認(rèn)知障礙的發(fā)生。
[Abstract]:Objective to observe the effects of lumbar plexus combined with sciatic nerve block and sevoflurane on cognitive function and serum brain-derived nerve growth factor (BDNF) in elderly patients after hip surgery.Methods 70 cases of unilateral total hip replacement were retrospectively analyzed and divided into control group (n = 35) and observation group (n = 35) according to random digital table, the patients in control group were treated with routine tracheal intubation general anesthesia, combined with intravenous administration of propofol.The observation group was treated with lumbar plexus block and sciatic nerve block, followed by tracheal intubation general anesthesia, combined with sevoflurane inhalation anesthesia to maintain the operation time, blood loss and adverse reactions in the two groups.The scores of mini-mental state scale (MMSE), Montreal Cognitive Assessment scale (MMA) and serum BDNF were evaluated on the 1st and 3rd day after operation, and the correlation between the serum BDNF level and MMSE and MoCA scores were analyzed.Results the scores of MMSE and MoCA and the level of serum BDNF in the observation group were significantly higher than those in the control group on the 1st and 3rd day after operation, the serum BDNF levels in the observation group were positively correlated with MMSE and MoCA, and the incidence of adverse reactions in the observation group was significantly lower than that in the control group (P 0.01).Conclusion Lumbar plexus combined with sciatic nerve block combined with sevoflurane can significantly increase serum BDNF level and reduce cognitive impairment in elderly patients with hip joint.
【作者單位】： 青海大學(xué)附屬醫(yī)院麻醉科;
【分類號】：R614

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