全麻联合硬膜外麻醉对老年膝关节置换术患者苏醒时间及认知功能的影响
刘兆杰
（富平县医院，陕西 渭南，711700）
浏览次数：99次 下载次数：404次
摘要：
目的 探讨全麻联合硬膜外麻醉对老年膝关节置换术患者苏醒时间及认知功能的影响。方法 将在我院进行膝关节置换术治疗的100例老年患者随机分为观察组与对照组，每组50 例。对照组行全身麻醉，观察组行全身麻醉联合硬膜外麻醉。 比较两组患者认知功能评分、并发症发生情况及苏醒时间。结果 与对照组比较，观察组术后1、2、3 d 认知功能评分均较高， 苏醒所用时间较短，差异具有统计学意义（P<0.05）；观察组并发症总发生率低于对照组，差异具有统计学意义（P<0.05）。 结论 全麻联合硬膜外麻醉能够缩短患者的苏醒时间，减少术后的并发症，有助于患者术后认知功能的恢复，值得临床应用。
关键词：全身麻醉；硬膜外麻醉；膝关节置换术；苏醒时间；认知功能
中图分类号：R614.2文献标志码：A文章编号：2096-1413(2017)30-0050-02
Effect of general combined epidural anesthesia on postoperative awakening time and cognitive function in
elderly patients with total knee arthroplasty
LIU Zhao-jie
(Fuping County Hospital, Weinan 711700, China)
ABSTRACT: Objective To investigate the effect of general combined with epidural anesthesia on postoperative awakening time and cognitive function in elderly patients with total knee arthroplasty. Methods A total of 100 elderly patients with total knee arthroplasty in our hospital were selected and randomly divided into observation group and control group, with 50 cases in each group. The control group took general anesthesia, and the observation group took general combined epidural anesthesia. The cognitive function, complications and awakening time of the two groups were compared. Results Compared with the control group, in the observation group the scores of cognitive function after surgery for 1, 2, 3 d were higher, and awakening time was shorter (P<0.05). The total incidence of complications of the observation group was lower than that of the control group (P<0.05). Conclusion General combined with epidural anesthesia can shorten awakening time, reduce postoperative complications and facilitate postoprative recovery of cognitive function, which is worthy of clinical application.
KEYWORDS: general anesthesia; epidural anesthesia; total knee arthroplasty; awakening time; cognitive function
参考文献：
[1] 吕雪彩,曹江北,潘伟,等.不同麻醉方法对单膝关节置换术患者围 术期应激反应的影响[J].解放军医学院学报,2016,37(4):304-307.
[2] 刘丹,汪涛,闵苏,等.两种镇痛方式对全膝关节置换术后患者凝血 功能的影响[J].第三军医大学学报,2016,38(13):1534-1537.
[3] 王继琛,李菁,王乐.不同镇痛模式在全膝关节置换术后镇痛效果 评价[J].中国综合临床,2014,30(z1):55-58.
[4] 许晓勤,许旭东,金娴冰,等.超声定位与神经刺激仪定位行全膝关 节置换术后镇痛效果的比较[J].临床麻醉学杂志,2014,30(7):634-636.
[5] 王春爱,赵振文,王承祥.局部浸润罗哌卡因联合静脉镇痛对全膝 关节置换术后镇痛及早期康复的影响[J].临床骨科杂志,2014,17(3):274-276.
[6] 李民,胡秋芳,杨高.不同麻醉管理方法对双侧全膝关节置换术后 栓塞的预防[J].河北医药,2014,36(3):359-360.
[7] 陆文博,杨世忠,邵学泉.全身麻醉与连续硬膜外麻醉对全膝关节 置换术围术期血液保护及深静脉血栓发生率的影响[J].中国医药导 报,2013,10(35):109-111.
[8] 龚小芳,李昊.不同麻醉方式对全膝关节置换术后深静脉血栓发生 率的影响[J].血栓与止血学,2015,21(3):157-159.