七氟醚吸入麻醉对老年股骨粗隆间骨折患者PFNA术后认知功能障碍影响.docVIP

七氟醚吸入麻醉对老年股骨粗隆间骨折患者PFNA术后认知功能障碍的影响 　　【摘要】 目的：分析七氟醚吸入麻醉??接受股骨近端内固定系统（PFNA）手术治疗的老年股骨粗隆间骨折患者术后认知功能的影响。方法：选取本院72例拟接受PFNA手术治疗的老年股骨粗隆间骨折患者作为观察对象，按照随机数字表法将患者分为应用丙泊酚麻醉的对照组与应用七氟醚麻醉的观察组，每组36例。对两组术后的认知功能情况进行分析。结果：两组间简易智力状态检查量表（MMSE）评分、术后恢复质量评估（PQRS）评分及韦氏成人记忆量表记忆商（MWS记忆商）均呈先降低后升高趋势（P0.05），但术后1、7、14 d时，观察组MMSE评分、PQRS评分及MWS记忆商均高于对照组（P0.05）。两组皮质醇浓度（E）及皮质醇（COR）水平均呈先升高后降低趋势（P0.05），而术后1、7、14 d时，观察组E、COR水平均低于对照组（P0.05）。结论：七氟醚吸入麻醉可有效改善接受PFNA手术治疗的老年股骨粗隆间骨折患者术后认知功能，其可能与改善患者应激反应有关。 　　【关键词】 七氟醚麻醉； 老年股骨粗隆间骨折； PFNA； 认知功能障碍 　　Effects of Sevoflurane Inhalation Anesthesia on Postoperative Cognitive Dysfunction of Patients with Old Age Intertrochanteric Fracture after PFNA Operation/ZHOU Xiaofeng，CHEN Yuansheng，GU Suya，et al.//Medical Innovation of China，2018，15（08）：112-115 　　【Abstract】 Objective：To analyze the effects of Sevoflurane inhalation anesthesia on postoperative cognitive function of old age intertrochanteric fracture after PFNA operation.Method：A total of 72 cases of PFNA operation of elderly patients with femoral intertrochanteric fracture as research object.According to the random number table method，they were divided into control group which using propofol anesthesia and observation group using sevoflurane anesthesia，36 cases in each group.The cognitive function after operation of two groups were analyzed.Result：The simple mental state checklists（MMSE）score，postoperative recovery quality assessment（PQRS）score and the memory quotient of Wechsler’s adult memory scale（MWS）of two groups were compared，there were statistical significance（P0.05）.However，on the first day，the seventh day and fourteenth day after operation，MMSE scores and MWS memory quotient in the observation group were higher than those in the control group（P0.05）.The concentration of cortisol（E）and the level of cortisol（COR）in two groups increased first and decreased then（P0.05）.On the first day，the seventh day and the fourteenth day after operation，the levels of E and COR in the observation group were lower than tho