目的:对比全麻和腰丛-坐骨神经阻滞应用于老年髋关节置换术中的麻醉效果以及对患者血流动力学、术后认知功能的影响。方法:选择2017年6月至2020年6月于嘉兴市第一医院接受髋关节置换的老年患者114例。根据不同麻醉方式分为采用全麻的对照组和采用腰丛-坐骨神经阻滞的观察组，每组各57例。记录患者苏醒、定向力恢复、拔管时间以及感觉阻滞、恢复痛觉、麻醉起效时间。观察患者在麻醉前、麻醉后15 min、术后15 min的心率(HR)、平均动脉压(MAP)变化。比较患者术前、术后6、24、72 h的简易智能检查状态评分(MMSE)变化。记录患者术后不良反应发生情况。结果:观察组苏醒时间、定向力恢复时间、拔管时间均少于对照组(n P<0.05)；观察组麻醉起效时间、感觉阻滞时间、恢复痛觉时间均少于对照组(n P<0.05)。对照组麻醉后15 min、术后15 min HR、MAP均低于麻醉前(n P<0.05)，观察组麻醉后15 min HR、MAP均低于麻醉前(n P<0.05)，且观察组麻醉后15 min、术后15 min HR、MAP均高于对照组(n P<0.05)。对照组术后6、24 h MMSE评分均低于术前(n P<0.05)，观察组术后6 h MMSE评分低于术前(n P<0.05)，且观察组术后6、24 h MMSE评分均高于对照组(n P<0.05)。观察组不良反应总发生率(8.77%)低于对照组(22.81%)(n P<0.05)。n 结论:相较于全麻，腰丛-坐骨神经阻滞麻醉效果更佳，患者术中血流动力学更稳定，并且对术后认知功能影响更小，安全性好。“,”Objective:To compare the application of general anesthesia and lumbar plexus-sciatic nerve block in elderly hip replacement surgery and the effects on the anesthesia effect, hemodynamics, and postoperative cognitive function of patients.Methods:A total of 114 elderly patients who received hip replacement in the First hospital of Jiaxing from June 2017 to June 2020 were selected. According to different anesthesia methods, they were divided into control group with general anesthesia and observation group with lumbar plexus sciatic nerve block, 57 cases in each group. The recovery time of recovery of orientation, extubation time, sensory block, recovery of pain and onset time of anesthesia were recorded. The changes of heart rate (HR) and mean arterial pressure (MAP) were observed before anesthesia, 15 minutes after anesthesia and 15 minutes after operation. The changes of mini-mental state examination (MMSE) score before operation, 6 h, 24 h and 72 h after operation were compared. The incidence of adverse reactions was recorded.Results:The recovery time, orientation recovery time and extubation time in the observation group were less than those in the control group (n P<0.05); the anesthesia onset time, sensory block time and pain recovery time in the observation group were less than those in the control group (n P<0.05). The HR and MAP of the control group at 15 min after anesthesia and 15 min after operation were lower than those before anesthesia (n P<0.05), while the HR and MAP 15 min after anesthesia in observation group were lower than those before anesthesia (n P<0.05); the HR and MAP of the observation group at 15 min after anesthesia and 15 min after operation were higher than those of the control group (n P<0.05). The MMSE scores at 6 h and 24 h in the control group were lower than those before the operation (n P<0.05), and the MMSE scores at 6 h in the observation group were lower than those before the operation (n P<0.05); the MMSE scores at 6 h and 24 h in the observation group were higher than those in the control group (n P<0.05). The total incidence of adverse reactions in the observation group (8.77%) was lower than that in the control group (22.81%) (n P<0.05).n Conclusions:Compared with general anesthesia, lumbar plexus sciatic nerve block anesthesia effect is better, with stable hemodynamics, smaller impact on postoperative cognitive function and good safety.