心理干预对老年患者经尿道前列腺电切术后认知功能影响.docVIP

心理干预对老年患者经尿道前列腺电切术后认知功能影响 　　【摘要】 目的：探讨心理干预对老年患者经尿道前列腺电切术后认知功能的影响。方法：选取择期拟行经尿道前列腺电切术患者80例，年龄63～81岁，身体质量指数（Body Mass Index， BMI）17～26 kg/m2，美国麻醉医师协会（ASA）分级Ⅰ～Ⅱ级，均采用持续硬膜外麻醉，随机数字表法分为干预组和对照组，每组40例。干预组于术前2天开始心理干预，对照组按常规术前麻醉查房。分别记录两组患者的手术时间、局麻药用量、丙泊酚用量，并分别于术前48 h、术后12、24、48 h对其进行简易智力状态检查（MMSE）评分；对各组患者术后各时间点MMSE评分和术后认知功能障碍（POCD）发生率进行比较。结果：两组患者的手术时间、局麻药用量和丙泊酚用量相比较，差异无统计学意义（P0.05）；心理干预组在术后各时间点的MMSE评分及POCD发生率明显低于对照组，比较差异有统计学意（P0.05）。结论：心理干预可以减少经尿道前列腺电切术后老年患者POCD的发生，使老年患者平稳度过围术期。 　　【关键词】 经尿道前列腺电切术； 老年患者； 心理干预； 术后认知功能 　　The Effect of Psychological Intervention on the Cognitive Function of Elderly Patients after Transurethral Resection of Prostate/HU Mo-wen， GU Yue-feng， HE Jian-ming， et al.//Medical Innovation of China，2016，12（04）：072-075 　　【Abstract】 Objective： To explore the effect of psychological intervention on the cognitive function after transurethral resection of prostate for elderly patients. Method： 80 patients who accepted transurethral resection of prostate operation， 63-81 years old， with 17-26 kg/m2 body mass index （BMI）， and Ⅰ-Ⅱ ASA classification， received continuous epidural anesthesia and were randomly divided into intervention group and control group， 40 cases in each group. Psychological intervention started in the intervention group at 2 days before general anesthesi， while the control group received routine preoperative anesthetic interview. Operation time， dosage of local anesthetic， and propofol were recorded. The minimum mental state examination （MMSE） was performed for 48 h before operation and 12， 24， and 48 hours after operation respectively. MMSE score and the incidence of post operative cognitive dysfunction （POCD） were compared as criterion. Result： There was no statistically significant difference between the two groups in operation time， dosage of local anesthetic and propofol （P0.05）. The MMSE score at each time point after operation of the intervention group， as well as incidence of POCD， was significantly lower than that of the control gro