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首页> 美国卫生研究院文献>International Journal of Clinical and Experimental Medicine >Effects of different anesthesia methods on cognitive dysfunction after hip replacement operation in elder patients
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Effects of different anesthesia methods on cognitive dysfunction after hip replacement operation in elder patients

机译：不同麻醉方法对老年髋关节置换术后认知功能障碍的影响

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摘要

There are many risk factors for the cause of postoperative cognitive dysfunction (POCD), however, the anesthesia selection always trigger controversy for the POCD occurrence. This study aims to explore the relationship between the anesthesia and the occurrence of POCD in elder patients, and also investigate the mechanism of the POCD. One hundred elder patients with hip replacement were included in this study, which were divided into general anesthesia (GA) and epidural analgesia (EA) group. Minimum mental state examination (MMSE) method was employed to assess the nervous and mental function (POCD) in both analgesia group patients. Aβ and tau protein levels in blood were detected by using the ELISA assay. The correlation between MMSE in POCD patients and Aβ or tau was analyzed by employing the Spearman rank correlation method. The results indicated that epidural analgesia decreases the MMSE scoring compared to general analgesia (P < 0.05). General analgesia enhanced the Aβ and tau level compared to epidural analgesia (P < 0.05). Aβ and tau level were increased in the patients with POCD. The POCD occurrence rate in GA group was significantly higher compared to EA group (P < 0.05). MMSE scores of POCD patients positively correlated with Aβ or tau level (P < 0.05). In conclusion, the epidural analgesia method was better than general analgesia method for the hip replacement in elder patients. The mechanism of the POCD may be caused by the enhancement of Aβ and Tau protein.
机译：术后认知功能障碍（POCD）的病因有很多危险因素，但是，麻醉的选择总是引发POCD发生争议。本研究旨在探讨老年患者麻醉与POCD发生的关系，并探讨POCD的作用机理。这项研究包括了100名老年髋关节置换患者，分为全麻（GA）和硬膜外镇痛（EA）组。两种镇痛组患者均采用最低精神状态检查（MMSE）方法评估神经和精神功能（POCD）。通过ELISA法检测血液中的Aβ和tau蛋白水平。采用Spearman秩相关法分析POCD患者MMSE与Aβ或tau的相关性。结果表明，硬膜外镇痛比普通镇痛降低了MMSE评分（P <0.05）。与硬膜外镇痛相比，一般镇痛可提高Aβ和tau水平（P <0.05）。 POCD患者的Aβ和tau水平升高。 GA组POCD发生率明显高于EA组（P <0.05）。 POCD患者的MMSE评分与Aβ或tau水平呈正相关（P <0.05）。总之，在老年患者中，硬膜外镇痛方法优于普通镇痛方法。 POCD的机制可能是由Aβ和Tau蛋白的增强引起的。

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