不同麻醉方法对老年患者术后早期认知功能影响.docVIP

不同麻醉方法对老年患者术后早期认知功能影响[摘要] 目的 探讨不同麻醉方法对老年患者术后早期认知功能的影响。方法 240例老年患者依据不同麻醉方法分为局麻组80例、硬麻组80例、全麻组80例，分别于术前和术后1、3、5d应用简易智能量表（MMSE）评定其认知功能，并对另外5个可能影响老年患者术后认知功能的因素（年龄、性别、受教育程度、手术时间、术前认知功能评分）进行Logistic分析。结果 全麻组术后1、3d MMSE评分降低明显（P＜0.05），但全麻组与硬麻组和局麻组相比无统计学意义（P＞0.05）。单因素分析有统计学意义的危险因素是年龄、手术时间和术前MMSE评分（P＜0.05），多因素非条件Logistic回归分析发现，患者的年龄是一个独立危险因素（P＜0.05）。结论 老年患者全麻手术后早期认知功能下降明显，但不同麻醉方法对老年患者术后早期发生认知功能障碍的影响无统计学差异。年龄是老年患者术后早期发生认知功能障碍的一个有显著性意义的危险因素。 [关键词] 老年患者；认知功能；术后认知功能障碍 [中图分类号] R614[文献标识码] B[文章编号]1673-9701（2011）21-121-03 The Impact of Anaesthesia Type on Cognitive Function during the Early Postoperative Days in Elderly Patients CHEN Fengwei1 LI Jun2 LIAN Qingquan2 1.Department of Anesthesiology, Yiwu City Central Hospital in Zhejiang Province,Yiwu 322000, China； 2. Department of Anesthesiology, The Second Affiliated Hospital of Wenzhou Medical College,Wenzhou 325027, China [Abstract] Objective To explore the impact ofAnaesthesia type on cognitive function during the early postoperative days in elderlypatients Methods Two hundreds and fouty elderly patients were divided into three groups: local anesthesia group , epidural anesthesia group or general anesthesia group of 80 casas respectively. The cognitive function of the patients was assessed preoperative and on the 1st , 3rd and 5th postoperative day with the Mini Mental State Examination（MMSE）. According to clinical experience, five factors correlated with the complications of postoperative cognitive dysfunction （POCD）in elderly patient , including age, gender ,level of education, duration of operation, MMSE scores before operation , we used multiple logistic regression analysis to find risk factors .Results Compared with the baseline values the MMSE scores decreased significantly on the 1st and 3rd postoperative day in GA group(P＜0.05), .There was not statistically significant between GA and LA groups or EA groups. Through univariate analysis using chi-square, the complications of POCD were significantly associa