【摘要】 目的 探讨和分析腰-硬联合麻醉对老年髋部骨折手术患者的疼痛和认知功能的影响。方法 选取本院2020年1月至2024年10月收治的104例老年髋部手术患者作为研究对象，其中对照组（52例）患者采用全凭静脉麻醉，观察组（52例）采用腰-硬联合麻醉。比较两组患者的MMSE评分、术后的VAS评分以及手术前、手术开始0.5 h和术后1 h的心率和平均动脉压情况，观察比较两组患者的麻醉相关指标。结果 观察组患者术后1 d和术后3 d的MMSE评分高于对照组患者（P<0.05），同时观察组患者在术后1 d和术后3 d的VAS评分均低于对照组患者（P<0.05），差异具有统计学意义，而在术后7 d两组患者的VAS评分差异无统计学意义（P>0.05）；两组患者在手术前、手术开始0.5 h和术后1 h的心率和平均动脉压相当（P>0.05）；对照组患者的麻醉起效时间和麻醉操作时间均短于观察组（P<0.05），差异有统计学意义。结论 老年髋部骨折手术患者采用腰-硬联合麻醉对其认知功能影响较全凭静脉麻醉小，能减轻疼痛，且对心率和平均动脉压没有负面作用。更多还原

【Abstract】 Objective To investigate and analyze the effects of combined spinal-epidural anesthesia on pain and cognitive function in elderly patients undergoing hip fracture surgery. Methods A total of 104 elderly patients who underwent hip surgery in our hospital from January 2020 to October 2024 were enrolled. The control group(52 cases) received total intravenous anesthesia, while the observation group(52 cases) received combined spinal-epidural anesthesia. Mini-Mental State Examination(MMSE) scores, postoperative Visual Analog Scale(VAS) scores, and heart rate and mean arterial pressure before surgery, at 0.5 h after surgery began, and at 1 h postoperatively were compared between the two groups. Anesthesia-related indicators were also evaluated. Results The observation group had significantly higher MMSE scores than the control group at 1 and 3 days postoperatively(P<0.05). VAS scores in the observation group were significantly lower than those in the control group at 1 and 3 days postoperatively(P<0.05), while no significant difference was observed between the groups at 7 days postoperatively( P<0.05). Heart rate and mean arterial pressure at the three time points(before surgery, 0.5 h after surgery began, and 1 h postoperatively) were comparable between the two groups( P<0.05). The induction time and anesthesia procedure duration were shorter in the control group than in the observation group( P<0.05). Conclusion Compared with total intravenous anesthesia, combined spinal-epidural anesthesia exerts less impact on cognitive function, provides better postoperative pain relief, and does not adversely affect heart rate or mean arterial pressure in elderly patients undergoing hip fracture surgery.更多还原