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1、不同麻醉方法对改善老年患者术后认知功能障碍的临床效岳阳市一人民医院麻醉科湖南岳阳414000【摘要L目的研究不同麻醉方法对改善老年患者术后认知功能障碍的效果。方法选取2013年2月至2016年2月在我院行手术治疗的老年患者100例，分为观察组与对照组，各50例，对照组使用全身麻醉的方式，观察组使用腰麻联合硬膜外麻醉方式，对比分析两组患者术后的认知功能障碍情况。结果对照组患者术后3d、7d与术前3d比较，MMSE评分均明显减低，差异有统计学意义(P<0.05),观察组患者术后3d、术前3d比较，MMSE评分均明显
2、减低，差异有统计学意义(P<0.05),但术后7d与术前3d比较差异无统计学意义(P〉0.05);2组间比较，观察组患者术后3d、7d与对照组术后3d、7d比较，MMSE评分差异有统计学意义(P<0.05)。2组患者手术前后HDS比较，观察组患者术后3d、术前3d、术后7d均低于对照组患者评分，差异有统计学意义(P<0.05)。观察组患者POCD发生率为18.0%低于对照组患者POCD发生率36.0%。结论对老年患者行腰硬联合麻醉，可以降低术后认知功能障碍的发生率，改善患者生活质量,具有临床应用的价值。【关键词
3、】：麻醉方法；老年患者；认知功能障碍[Abstract]Objective:Tostudytheeffectofdifferentanestheticmethodsontheimprovementofpostoperativecognitivedysfunctioninelderlypatients.MethodsFebruary2013to20162monthsinourhospitalunderwentsurgicaltreatmentof100casesofelderlypatients,dividedi
4、ntotheobservationgroupandthecontrolgroup,50casesineach,controlgroupusegeneralanesthesia,theobservationgroupusingspinalanesthesiacombinedwithepiduralanesthesiaway,comparativeanalysistwogroupsofpatientswithpostoperativecognitivedysfunction.Resultsinthecontrolg
5、roupofpatientsafter3D,7dandpreoperativein3days,MMSEscoreweresignificantlydecreased,thedifferenceisstatisticallysignificant(P<0.05),theobservationgroupofpatientsafter3D,beforeoperationin3days,MMSEscoreweresignificantlydecreased,thedifferenceisstatistically
6、significant(P<0.05),butpostoperative7dandpreoperative3Ddifferencenostatisticalsignificance(P>0.05);betweenthetwogroupswereobservedandcompared.Groupofpatientsafter3days,7daysandthecontrolgroupafter3D,7d,MMSEscoredifferencehasstatisticalsignificance(P<
7、;0.05).The2groupsofpatientsbeforeandaftersurgeryHDScomparison,theobservationgroupofpatientsafter3D,preoperative3D,postoperative7dwerelowerthanthecontrolgrouppatientsscore,thedifferencewasstatisticallysignificant(P<0.05).TheincidencerateofPOCDintheobservat
8、iongroupwas18%lowerthanthatofthecontrolgroup,theincidencerateofPOCDwas36%.Conclusioncombinedspinalepiduralanesthesiainelderlypatientscanreducetheincidenceofpostoperativecognitivedysfunctionandim
