不同麻醉方式对老年髋关节置换术后谵妄、精神状态、苏醒期躁动及认知功能的影响
Effects of different anesthetic modalities on delirium, mental status, emergence agitation and cognitive function in elderly patients after hip replacement
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| DOI |
| 刊名 |
Journal of International Psychiatry
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| 年，卷(期) |
2021, 48(3) |
| 作者 |
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| 作者单位 |
河南医学高等专科学校附属医院麻醉科 ;
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| 摘要 |
[摘要]目的：探讨不同麻醉方式对老年髋关节置换术后谵妄、精神状态、苏醒期躁动及认知功能的影响。方法：选取2018年6月～2020年6月我院行老年髋关节置换术患者65例，采用右美托咪定、硬膜外复合全身麻醉的31例患者纳入观察组，采用全身麻醉的34例患者纳入对照组，比较两组麻醉效果，术后精神状态评分（MMSE）及谵妄、认知功能障碍（POCD）、苏醒期躁动发生情况。结果：观察组麻醉时间及术后睁眼时间、拔管时间、语言陈述时间均短于对照组，差异有统计学意义（P<0.05）。观察组术后1h、术后6h、术后12h、术后24h、术后48h的MMSE评分均高于对照组，且随着时间延长，MMSE评分越高（P<0.05）。观察组术后谵妄、POCD发生率低于对照组，且观察组术后谵妄持续时间短于对照组，差异有统计学意义（P<0.05）。观察组术后苏醒期躁动发生率为35.48%，低于对照组的73.53%，差异有统计学意义（P<0.05）。结论：右美托咪定、硬膜外复合全身麻醉有助于降低老年髋关节置换术患者术后精神状态及认知功能的影响，促进患者意识恢复，减少术后谵妄、POCD、苏醒期躁动发生。
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| Abstract |
[Abstract] Objective: To investigate the effects of different anesthesia methods on delirium, mental states, emergence agitation and cognitive function in elderly patients after hip replacement. Methods: 65 patients with hip replacement in our hospital from June 2018 to June 2020 were selected, 31 patients with dexmedetomidine and epidural general anesthesia were included in the observation group, and 34 patients with general anesthesia were included in the control group. The anesthesia effect, MMSE scores, delirium, POCD and emergence agitation were compared between the two groups. Results: The anesthesia time, postoperative eye opening time, extubation time and language statement time of the observation group were shorter than those of control group (P<0.05). The MMSE scores of the observation group at 1 h, 6 h, 12 h, 24 h and 48 h were higher than those of control group, and the higher the MMSE score was with the extension of time (P<0.05). The incidence of postoperative delirium and POCD in the observation group was lower than that of control group, and the duration of postoperative delirium in the observation group was shorter than that of control group(P<0.05). The incidence of restlessness in the observation group (35.48%) was lower than that of control group (73.53%) (P<0.05). Conclusion: Dexmedetomidine combined with epidural anesthesia can reduce the influence of mental state and cognitive function in elderly patients after hip replacement, promote the recovery of consciousness, and reduce postoperative delirium, POCD and emergence agitation.
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| 关键词 |
[关键词]老年；髋关节置换术；麻醉；谵妄；精神状态；苏醒期躁动；认知功能
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| KeyWord |
[Key words] Elderly patients; Hip replacement; Anesthesia; Delirium; Mental states; Emergence agitation; Cognitive function
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| 基金项目 |
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| 页码 |
488-491 |
吕清香*.
不同麻醉方式对老年髋关节置换术后谵妄、精神状态、苏醒期躁动及认知功能的影响 [J].
国际精神病学杂志.
2021; 48; (3).
488 - 491.