摘要目的 探讨星状神经节阻滞(SGB)对老年患者术后注意力与执行功能的影响. 方法 腰麻下行髋关节置换术中老年患者(55～75岁)随机分为无干预对照组(CON组)与星状神经节阻滞组(SGB组),SGB组患者于术前30 min行超声引导下左侧SGB,CON组不做任何处理.所有患者分别于术前1d与术后第7天进行改良版连线测验A部分(TMT-A)与改良版数字符号测验(SDMT)测试,采用“Z计分法”诊断患者术后是否发生术后注意力与执行功能障碍. 结果 改良版TMT-A与SDMT在中国55～75岁中老年人群具有较好的适用性,年龄是两测验的主要影响因素,且两测验的两个平行版本均具有较好的复本信度.术后第7天,SGB组与CON组TMT-A与SDMT得分均无显著差异(P＞0.1),但SGB组术后注意力与执行功能障碍的发生率低于CON组(P＜0.05),其中SGB组发生率为19.3％,CON组发生率为36.6％. 结论 改良版TMT-A与SDMT在中国中老年人群具有较好适用性;术前预防性SGB有助于保护中老年患者术后注意力与执行功能.

abstractsObjective To investigate the effects of stellate ganglion block(SGB)on attention and executive function in middle-aged and elderly patients after surgery.Methods Middle-aged and elderly patients aged 55-75 years who underwent hip replacement surgery under lumbar anesthesia were randomized into a control group and an SGB group.Patients in the SGB group received ultrasound-guided stellate ganglion block 30 min before surgery,and patients in the control group were given no additional treatment before surgery.All patients were tested with a modified version of the Trail Making Test-Part A (TMT-A)and a modified version of the Symbol Digit Modalities Test (SDMT)1 day before surgery and 7 days after surgery.The Z-score method was used to diagnose postoperative attention and/or executive function impairment.Results The modified versions of TMT-A and SDMT had good reliability and validity among Chinese middle-aged and elderly people aged 55-75 years.Age was the main influencing factor for the two tests,and their two parallel versions had good alternate-form reliability.There was no significant difference between the control group and the SGB group in scores of modified TMT-A and SDMT at 7 days after surgery(P＞0.1).However,the incidence of attention and/or executive function impairment was lower in the SGB group than in the control group(19.3％ vs.36.6％,P＜0.05).Conclusions The modified TMT-A and SDMT have good reliability and validity among Chinese middle-aged and elderly people aged 55-75 years.Preoperative SGB may protect attention and executive function in middle-aged and elderly patients.