不同麻醉方式对老年TKA术患者苏醒时间及认知恢复的影响.docVIP

精品论文 参考文献 不同麻醉方式对老年TKA术患者苏醒时间及认知恢复的影响 李胜 邱英群（通讯作者） 　　（綦江区人民医院麻醉科 重庆 綦江 401420） 　　【摘要】 目的：探讨不同麻醉方式对老年全膝关节置换（TKA）术患者苏醒时间及认知恢复的影响。方法：将老年TKA术患者96例随机分两组，对照组48例实施全身麻醉，观察组48例实施全身麻醉复合硬膜外麻醉。结果：观察组吞咽反射出现时间、拔管时间、定向力恢复时间均明显早于对照组（P＜0.05）。观察组术后1d、2d、3d时MMSE评分均明显高于对照组（P＜0.05）。结论：与全身麻醉相比，全身麻醉复合硬膜外麻醉可明显缩短老年TKA术患者的苏醒时间，减轻疼痛并改善术后认知功能状况。 　　【关键词】麻醉方式；老年；全膝关节置换术；苏醒时间；认知恢复；影响 　　【中图分类号】R614 【文献标识码】A 【文章编号】2095-1752（2016）19-0167-02 　　Influence of different?anesthesia Methods on recovery time?and?cognitive recovery in elderly patients with?TKA operation 　　Li Sheng 　　College of Clinical Applied Technology, Medical University Of Chongqing, 400050 　　【Abstract】 Objective To investigate influence of different?anesthesia Methods on recovery time?and?cognitive recovery in elderly patients with?TKA operation. Methods 96 elderly patients with TKA operation were randomly?divided into two groups. 48 patients treated general anesthesia as control group. 48 patients treated general anesthesia?combined with epidural anesthesia as observation group. Results Emergence time of swallowing reflex; extubation time; orientation recovery time in observation group were significantly earlier than control group(Plt;0.05). MMSE score at postoperative 1d;2d;3d in observation group were significantly higher than control group (Plt;0.05).?Conclusion Compared with?general anesthesia,?general anesthesia combined with epidural anesthesia can significantly shorten recovery time in elderly patients with?TKA operation, which can also reduce pain and improve postoperative cognitive?function status. 　　【Key words】 Anesthesia method;?Elderly; Total knee arthroplasty; Recovery time; Cognitive recovery; Influence 　　随着人口老龄化的发展和身体机能的减弱，各种膝关节疾病在老年人中的发病率持续走高，严重威胁着老年人的身体健康。手术治疗是老年膝关节疾病的有效治疗方法［1-2］，常用术式之一为全膝关节置换术，而手术需要给予患者有效的麻醉，不同的麻醉方式取得的麻醉效果是不同的。此次研究对48例老年TKA术患者实施全身麻醉复合硬膜外麻醉，效果显著，现报告如下。 　　1.资料与方法 　　1.1 资料 　　本院2013年10月～2015年12月老年TKA术患者96例，经临床表现、实验室检查、影像学检查确诊，排除患有器质性疾病、血液性疾病、免疫性疾病、精神疾病、手术禁忌症、