本文選題：全身麻醉 + 局部麻醉��； 參考：《臨床醫(yī)藥實踐》2016年08期

【摘要】：目的:研究老年患者實施不同的麻醉方法手術(shù)對早期認(rèn)知功能產(chǎn)生的影響。方法:選擇2013年5月—2015年5月診治的120例老年手術(shù)患者,根據(jù)手術(shù)采取麻醉方法的不同分為三組,每組40例。A組實施局部麻醉;B組實施硬膜外麻醉;C組實施全身麻醉。分別在術(shù)前及術(shù)后的1,3,5 d對其認(rèn)知功能進行評定,同時運用Logistic分析可能對老年患者術(shù)后認(rèn)知功能產(chǎn)生影響的因素。結(jié)果:通過比較,C組患者術(shù)后1,3,5 d的簡易智力狀況檢查(MMSE)評分明顯比其他兩組低,差異有統(tǒng)計學(xué)意義(P0.05)。但是C組與A組和B組相比,術(shù)后出現(xiàn)認(rèn)知功能障礙的概率比較差異無統(tǒng)計學(xué)意義(P0.05)。運用單因素分析,對老年患者認(rèn)知功能產(chǎn)生影響的因素主要有患者年齡、手術(shù)時間、術(shù)前MMSE評分等,通過多因素非條件Logistic回歸分析能夠看出,年齡屬于一個獨立的危險因素。結(jié)論:老年患者手術(shù)操作實施全身麻醉對其認(rèn)知功能影響明顯,但是老年患者實施不同麻醉方法對其早期出現(xiàn)認(rèn)知功能障礙未見明顯差異,老年患者術(shù)后早期出現(xiàn)認(rèn)知功能障礙的一個明顯影響的因素是年齡。
[Abstract]:Objective: to study the effect of different anesthesia methods on early cognitive function in elderly patients.Methods: 120 elderly patients who were diagnosed and treated from May 2013 to May 2015 were divided into three groups according to different anesthetic methods. Each group (40 cases) was treated with local anesthesia. Group B was given epidural anesthesia and group C was given general anesthesia.The cognitive function was evaluated before and 5 days after operation, and the factors that might affect the cognitive function of the elderly patients were analyzed by Logistic analysis.Results: the MMSE score of group C was significantly lower than that of the other two groups (P 0.05).However, there was no significant difference between group C and group A and B in the incidence of cognitive dysfunction after operation (P 0.05).Using univariate analysis, the main factors influencing the cognitive function of elderly patients were age, operation time, preoperative MMSE score and so on. Through multivariate conditional Logistic regression analysis, we can see that age belongs to an independent risk factor.Conclusion: the effect of general anesthesia on the cognitive function of elderly patients is obvious, but there is no significant difference in the early occurrence of cognitive dysfunction in elderly patients with different anesthetic methods.Age is a significant factor affecting cognitive impairment in elderly patients early after surgery.
【作者單位】： 太原市人民醫(yī)院;
【分類號】：R614
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本文編號：1760141