| 郭晓丽 蒋敏 李海波△ 田永刚 梁立秋.不同麻醉方法对老年患者髋关节置换术术后认知功能障碍的影响[J].,2016,16(26):5106-5108 |
| 不同麻醉方法对老年患者髋关节置换术术后认知功能障碍的影响 |
| Effects of Different Anesthesia Methods on the Cognitive Dysfunction of Elder Patients after Hip Replacement Operation |
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| DOI： |
| 中文关键词: 全身麻醉 硬膜外麻醉 术后认知功能障碍 简易精神状态检查量表 |
| 英文关键词: General anesthesia Epidural analgesia Postoperative cognitive dysfunction Minimummental state examination(MMSE) |
| 基金项目:黑龙江省自然科学基金项目（D200821） |
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| 中文摘要: |
| 目的：比较全身麻醉和硬膜外麻醉两种麻醉方法对老年患者髋关节置换术术后发生认知功能障碍的影响并探讨其可能机
制。方法：选择ASAⅡ-Ⅲ 级行髋关节置换术的老年患者80 例，随机分为全身麻醉组(GA)和硬膜外麻醉组(EA)。采用简易精神状
态检查量表法(MMSE)评估两组患者术前1 天、术后1天、术后5 天的神经精神功能状态。采用酶联免疫吸附试验(ELISA)法检测
和比较患者术前1 天、术后1 天、术后5 天血清Aβ和tau蛋白水平。结果：GA 组术后1 天MMSE 评分、血清Aβ蛋白和tau 蛋白
表达均较术前1 天、术后5 天明显降低(P＜0.05)；EA组三个时间点相互比较无统计学差异。EA组T2 时间点MMSE 评分、血清
Aβ蛋白和tau蛋白表达显著高于GA组(P<0.05)。发生POCD的患者Aβ蛋白和tau 蛋白表达水平均较非POCD患者明显升高
(P＜0.05)。结论：硬膜外麻醉能明显降低行髋关节置换术老年患者术后POCD的发生，可能与减少Aβ蛋白和Tau 蛋白的表达有关。 |
| 英文摘要: |
| Objective:To compare the effect of general anesthesia and epidural analgesia on the occurrence of POCD in elderly
patients after hip replacement and investigate the possible mechanisms.Methods:Eighty elderly patients undergoing hip replacement
were enrolled in this study and were divided into the general anesthesia (GA) and epidural analgesia (EA) group. The minimum mental
state examination (MMSE) method was performed to assess the nervous and mental function (POCD). The Aβand tau protein levels in
blood were detected by using the ELISA assay.Results:Epidural analgesia decreased the MMSE scoring compared to general analgesia
(P<0.05). General analgesia enhanced the Aβand tau level compared to epidural analgesia (P<0.05). Aβand tau levels were increased in
the patients with POCD. The POCD occurrence rate in GA group was significantly higher compared to EA group (P<0.05).Conclusion:The epidural analgesia method was better than general analgesia method for the elderly patients undergoing hip replacement. POCD
might be caused by the enhancement of serumAβand Tau protein |
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