Objective To study the possible impact of various anesthesia on stress response and cognitive function of elderly patients having undergone thoracic surgery .Method 48 elderly patients having undergone thoracic surgery were randomly divided into two groups , 23 cases in the general anesthesia group were administered with general anesthesia , while 25 cases in the combined group were administered with general anesthesia combined with epidural anesthesia .Detected immediately before induction (T0), skin incision (T1), after incision 2 h (T2), after incision 4 h (T3), drug withdrawal (T4), after extubation 5min (T5) of cortisol (Cor ), epinephrine (E), norepinephrine (NE), interleukin-6 (IL-6), regional cerebral oxygen saturation (rSO2), changes, and using the Mini Mental state Examination (MMSE) evaluation of patients considered known functions .Findings The two groups after incision Cor , E, NE, IL-6 levels were higher than the baseline value, after incision 3 ~5h peaked, T2 ~T3 time group B Cor, E, NE, IL-6 levels below group A; Group Bcompared with intraoperative rSO2 basis fell less than in group A; Group B after 1d, 3dMMSE rated higher than that ofgroup A.The difference was statistically significant (P <0.05).Conclusion Thoracic surgery for elderly patients canelevate stress hormones.epidural anesthesia was found to be able to inhibit anesthesia .Epidural anesthesia can be used asthe preferred elderly thoracic surgery anesthesia .%目的：研究不同麻醉方法对老年胸科手术患者应激反应及认知功能的影响。方法将48例老年胸科手术患者随机分为两组，A组23例实施全麻，B组25例实施全麻复合硬膜外麻醉，检测诱导前即刻（T0）、切皮时（T1）、切皮后2h（T2）、切皮后4 h（T3）、停药时（T4）、拔管后5 min（T5）的皮质醇（Cor）、肾上腺素（E）、去甲肾上腺素（NE）、白细胞介素6（IL-6）、局部脑氧饱和度（rSO2）、变化，并采用简易精神状态检查表（MMSE）评价患者认知功能。结果两组切皮后Cor、E、NE、IL-6水平均高于基础值，切皮后3～5h达到最高峰，T2-T3时段B组Cor、E、NE、IL-6水平低于A组；B组术中rSO2较基础下降幅度小于A组；B组术后1d、3dMMSE评分高于A组，两组差异比较具有统计学意义（P＜0．05）；结论胸科手术使老年患者应激激素升高，硬膜外麻醉对此有一定的抑制作用，全麻复合硬膜外麻醉可作为老年胸科手术的首选麻醉方式。
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