目的 探究不同麻醉方式对老年髋部骨折患者术后认知功能及恢复的影响。方法 选择阳江市阳东区人民医院2018年4月—2021年4月收治的老年髋部骨折患者100例,分为对照组与观察组各50例。对照组采用传统静脉麻醉,观察组在对照组基础上复合局部浸润麻醉。观察比较两组痛觉阻滞起效时间、手术时间,不同时间Ramsay镇静评分、认知功能情况,术后下地活动时间及术后进食时间。结果 两组痛觉阻滞起效时间、手术时间差异无统计学意义（P>0.05）;观察组苏醒后5 min时Ramsay镇静评分高于对照组（P<0.05）,两组术前、术后蒙特利尔认知评估量表评分差异无统计学意义（P>0.05）;观察组术后下地活动时间及术后进食时间短于对照组（P<0.05）。结论 静脉麻醉复合局部浸润麻醉用于老年髋部骨折患者相对于静脉麻醉,术后镇静效果更稳定,可缩短术后下地活动时间及进食时间,不影响患者术后认知功能。
Objective To explore the effects of different anesthesia methods on postoperative cognitive function and recovery of elderly patients with hip fracture. Methods A total of 100 elderly hip fracture patients admitted to the People's Hospital of Yangdong District, Yangjiang City from April 2018 to April 2021 were selected and divided into a control group and an observation group （50 cases in each group） by lottery method. The control group was treated with traditional intravenous anesthesia, while the observation group was given local infiltration anesthesia on the basis of the control group. Comparisons between the two groups were made in the onset time of pain block, operation time, Ramsay sedation scores at different time points, cognitive function, postoperative time to get out of bed, and postoperative eating time. Results There was no significant difference in the onset time of pain block and operation time between the two groups （P>0.05）. The Ramsay sedation score of the observation group was higher than that of the control group at 5 min after awakening （P<0.05）. There was no significant difference in the scores of Montreal Cognitive Assessment before or after the surgery （P>0.05）. The observation group’s postoperative time to get out of bed and postoperative eating time were shorter than those of the control group （P<0.05）. Conclusion Comparing with intravenous anesthesia, intravenous anesthesia combined with local infiltration anesthesia for elderly patients with hip fracture has a more stable postoperative sedative effect, and it can shorten the postoperative time to get out of bed and and eating without affecting the postoperative cognitive function of the patients.
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