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目的:比较不同麻醉方式用于髋关节置换术的效果及对患者术后镇痛、术后认知功能障碍(POCD)和深静脉血栓(DVT)发生的影响。方法:选择2017年3月至2019年3月浙江省台州医院收治的行髋关节置换术患者96例，采用随机数字表法分为A组48例与B组48例。A组行硬膜外腔麻醉，B组行全身麻醉。比较两组围术期情况、麻醉效果、术后3 h、12 h和24 h患者视觉模拟评分(VAS)、术后1 d、3 d和7 d患者POCD和DVT发生情况。结果:两组手术时间、术中出血量和下床时间差异均无统计学意义(均n P>0.05)。A组苏醒时间[(14.98±2.31)min]和拔管时间[(17.35±3.54)min]均快于B组[(19.13±3.42)min和(22.18±2.87)min](n t＝6.967、7.343，均n P<0.05)；A组VAS评分术后3 h[(2.34±0.56)分]、12 h[(1.65±0.43)分]和24 h[(1.07±0.31)分]，均低于B组[(3.27±0.73)分、(2.45±0.38)分和(1.98±0.45)分](n t＝7.003、9.659、11.538，均n P<0.05)；A组术后3 d(10.42%)和7 d(2.08%)POCD发生率低于B组(33.33%、14.58%)(χn 2＝7.357、3.909，均n P<0.05)；A组术后3 d(4.17%)和7 d(8.33%)DVT发生率均低于B组(20.83%、29.17%)(χn 2＝6.095、6.838，均n P0.05). The recovery time[(14.98±2.31)min]and extubation time[(17.35±3.54) min]of group A were faster than those of group B[(19.13±3.42)min and (22.18±2.87)min](n t=6.967, 7.343, all n P<0.05). The VAS scores of group B at postoperative 3 h[(3.27±0.73)points], postoperative 12 h[(2.45±0.38)points]and postoperative 24 h[(1.98±0.45)points]were higher than those of group A[(2.34±0.56)points, (1.65±0.43)points and (1.07±0.31)points](n t=7.003, 9.659, 11.538, all n P<0.05). The incidences of POCD in group A at postoperative 3d(10.42%) and 7d(2.08%) were lower than those in group B (33.33% and 14.58%) (χn 2=7.357, 3.909, all n P<0.05). The incidences of DVT in group A at postoperative 3d(4.17%) and 7d(8.33%) were lower than those in group B (20.83% and 29.17%) (χn 2=7.357, 3.909, all n P<0.05).n Conclusion:Epidural anesthesia is superior to general anesthesia in hip replacement.Postoperative analgesia is superior to general anesthesia, and can reduce the occurrence of short-term POCD and DVT, which is worthy of clinical reference.