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目的:观察高压氧(HBO)综合治疗对老年全麻下行膝关节手术患者术后谵妄的治疗效果。方法:选择2017年10月至2019年7月烟台山医院骨科择期全麻下行膝关节置换手术患者194例，ASA分级为2～3级，按照数字表法随机分为观察组和对照组，每组97例。对照组患者全身麻醉下行膝关节置换术，缝皮时行膝关节鸡尾酒局部镇痛联合使用术后静脉镇痛泵镇痛，观察组患者在对照组治疗的基础上术前1 d及术后第1～3天行HBO治疗。记录2组患者各时间点的平均动脉压(MAP)、心率(HR)及手术后48 h的视觉模拟评分(VAS)，采用CAM-ICU量表评价2组患者术后5 d谵妄的发生率。结果:2组患者进手术室(T1)诱导后、喉罩置入后1 min(T2)、手术开始前(T3)、手术开始后30 min(T4)、拔喉罩前(T5)、入麻恢即刻(T6)、出麻恢(T7)各时间点的MAP和HR比较差异均无统计学意义(n P>0.05)；2组患者术后6、24、48 h VAS比较差异无统计学意义(n P>0.05)；观察组患者术后谵妄发生率(9.2%)明显低于对照组(28.9%)，差异有统计学意义(n P0.05) when the patients were taken to the operating room (T1), 1 minute after the insertion of laryngeal mask (T2), before the start of the surgery (T3), 30 minutes after the start of the surgery (T4), before the removal of the laryngeal mask (T5), taken to the post-anesthesia care unit immediately after surgery (T6), and taken out of the post-anesthesia care unit (T7). There was no significant difference in VAS scores between the two groups at 6, 24, and 48 hours after surgery (n P>0.05). The incidence of postoperative delirium in the HBO group (9.2%) was significantly lower than that in the control group (28.9%), with statistical significance (n P<0.05).n Conclusion:HBO can significantly reduce the incidence of postoperative delirium in elderly patients after total knee arthroplasty, which is worthy of popularization and application in clinic.