全身麻醉复合硬膜外阻滞麻醉对老年胸科手术患者应激反应及认知功能影响.docVIP

全身麻醉复合硬膜外阻滞麻醉对老年胸科手术患者应激反应及认知功能影响 　　摘要：目的 观察全身麻醉复合硬膜外阻滞麻醉对老年胸科手术患者应激反应及认知功能的影响。方法 将我院收治的86例老年胸科手术患者按照麻醉方式的不同分为观察组与对照组，每组各43例，对照组患者采用全身麻醉，观察组患者采用全身麻醉复合硬膜外阻滞麻醉，观察两组患者不同时间段的皮质醇（Cor）、肾上腺素（E）及去甲肾上腺素（NE）变化情况，并采用简易精神状态检查表（MMSE）对患者的认知功能进行评价结果 切皮后2h和切皮后4h观察组患者的Cor、E及NE水平明显低于对照组患者，组间差异有统计学意义（P0.05）。观察组患者术后1d和术后3d的MMSE评分均高于对照组患者，组间差异有统计学意义（P0.05），认知功能优于对照组患者。结论 全身麻醉复合硬膜外阻滞麻醉能够减轻老年胸科手术患者围手术期应激反应，改善患者术后的认知功能。 　　关键词：老年；胸科手术；全身麻醉复合硬膜外阻滞麻醉；应激反应；认知功能 　　Impact of Combined General-epidural Anesthesia on Stress Response and Cognitive Function of Elderly Patients who Undergoing Thoracic Surgery 　　SONG Xi 　　（Department of Anesthesiology，The Affiliated Hospital of Chengdu University of Traditional Chinese Medicine，Chengdu 610072，Sichuan，China） 　　Abstract：Objective To observe the impact of combined general-epidural anesthesia on stress response and cognitive function of elderly patients who undergoing thoracic surgery.Methods 86 elderly cases who undergoing thoracic surgery in our hospital were divided into observation group and control group，43 cases in each group，cases in control group taken general anesthesia，cases in observation group taken combined general-epidural anesthesia，observed cortisol（Cor）， epinephrine （E） and norepinephrine （NE）at different period，and used the mini mental state examination （MMSE） to evaluate the cognitive function.Results Cor，E and NE levels after incision 2 and 5h of cases in observation group were significantly lower than that in control group， there was significant difference between two groups（P0.05）.MMSE scores after operation 1d and 3d of cases in observation group were higher than that in control group，there was significant difference between two groups （P0.05），the cognitive function was better than control group.Conclusion Combined general-epidural anesthesia can reduce stress reaction and improve the cognitive function of elderly patients who undergoing thoracic surgery. 　　Key words：Elderly；Thoracic operation；Combined general-epidural anesth