解放军医药杂志2018，Vol.30Issue(5)：58-61,4.DOI:10.3969/j.issn.2095-140X.2018.05.015
全麻与腰硬联合麻醉对老年全膝关节置换术后精神状态的影响
Effect of General Anesthesia and CSEA on Mental Status in Elderly Patients after Total Knee Arthroplasty
摘要
Abstract
Objective To investigate effects of general anesthesia (GA) and combined spinal epidural anesthe-sia (CSEA) on mental status and incidence rate of deep venous thrombosis (DVT) in elderly patients after total knee ar-throplasty. Methods A total of 120 elderly patients with selectively total knee arthroplasty during May 2015 and May 2017 were divided into GA group (n = 60) and CSEA group (n = 60) according to anaesthetic ways. Mini-mental state examination (MMSE) was performed before surgery and at the 12th h, 24th h, 48th h and 72th h after surgery, and levels of brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) in peripheral blood were detected, and then incidence rates of postoperative delirium and DVT were recorded in two groups. Results MMSE scores, BNDF and NGF levels in peripheral blood were significantly decreased after surgery compared with those before surgery (P < 0. 05). In GA group, MMSE scores, BNDF and NGF levels in peripheral blood at the 12th h, 24th h, 48th h and 72th h after surgery were significantly lower (P < 0. 05), and incidence rates of postoperative delirium and DVT were significantly higher than those CSEA group (P < 0. 05). Conclusion Effects of CSEA cognitive function, mental status and incidence rate of DVT in elderly patients after total knee arthroplasty are significantly less than those by general anesthesia, which is help-ful in selection of anaesthetic ways in elderly patients with lower extremity surgery.关键词
全膝关节置换术/麻醉,全身/麻醉,硬膜外/精神状态/静脉血栓形成Key words
Total knee arthroplasty/Anesthesia/general/Anesthesia/epidural/Mental status/Venous throm-bosis分类
医药卫生引用本文复制引用
康春艳,朱建炜..全麻与腰硬联合麻醉对老年全膝关节置换术后精神状态的影响[J].解放军医药杂志,2018,30(5):58-61,4.基金项目
江苏省卫生计生委面上科研课题(H201524) （H201524）
