硬膜外麻醉与全身麻醉用于全膝关节置换术：对围手术期认知功能和深静脉血栓形成的影响。
Epidural Anesthesia versus General Anesthesia for Total Knee Arthroplasty: Influences on Perioperative Cognitive Function and Deep Vein Thrombosis.
机构信息
Department of Anesthesiology, PLA Rocket Force Characteristic Medical Center, Beijing 100088, China.
出版信息
Comput Math Methods Med. 2022 Sep 10;2022:4259499. doi: 10.1155/2022/4259499. eCollection 2022.
PURPOSE
This research mainly discussed the impacts of epidural anesthesia (EA) and general anesthesia (GA) on perioperative cognitive function (CF) and deep vein thrombosis (DVT) in patients undergoing total knee arthroplasty (TKA).
METHODS
One hundred and twenty-four patients undergoing TKA in our hospital between July 2015 and October 2021 were selected, of which 74 patients received EA (research group) and the other 50 patients received GA (control group). Perioperative CF, DVT, stress response indicators (norepinephrine, NE; cortisol, Cor), and heart rate (HR) levels were observed and compared. Risk factors affecting DVT of TKA patients were analyzed by logistic regression.
RESULTS
The research group had statistically better CF than the control group, with notably lower NE, Cor, and HR levels and incidence of DVT. Logistic regression analysis showed that the type of anesthesia and MoCA were risk factors for DVT in TKA patients.
CONCLUSION
EA is more feasible for patients undergoing TKA, which is conducive to improving their CF, relieving stress responses, and reducing the incidence of DVT, with a certain sedative effect.
目的
本研究主要探讨硬膜外麻醉（EA）和全身麻醉（GA）对全膝关节置换术（TKA）患者围手术期认知功能（CF）和深静脉血栓形成（DVT）的影响。
方法
选取我院 2015 年 7 月至 2021 年 10 月收治的 124 例行 TKA 的患者，其中 74 例行 EA（研究组），50 例行 GA（对照组）。观察并比较两组患者围手术期 CF、DVT、应激反应指标（去甲肾上腺素，NE；皮质醇，Cor）和心率（HR）水平。采用 logistic 回归分析 TKA 患者 DVT 的影响因素。
结果
研究组 CF 明显优于对照组，NE、Cor、HR 水平及 DVT 发生率均较低。logistic 回归分析显示，麻醉方式和 MoCA 是 TKA 患者 DVT 的危险因素。
结论
EA 对 TKA 患者更可行，有利于改善 CF，减轻应激反应，降低 DVT 发生率，具有一定的镇静作用。
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