中文摘要：

目的探索骨科手术中应用全身麻醉或椎管内麻醉对术后认知功能的影响。方法采用Meta分析的方法，系统检索PubMed、EMbase、Cochranelibrary、Oviddatabase、CNKI、万方数据库、维普数据库，检索时限均为建库至2014年10月31日．收集研究骨科手术中分别应用全身麻醉和椎管内麻醉对于术后认知功能障碍发生率影响的随机对照试验。使用Revman5_3软件对数据进行统计学分析。结果骨科手术中蛛网膜下腔麻醉与全身麻醉相比，术后认知功能障碍的发生率差异无统计学意义（RR=I．83，95％C10．72～4．65，P=0．20）；骨科手术中硬膜外麻醉术后认知障碍的发生率显著低于全身麻醉（RR=I．37，95％CI1．00-1．88，P=0．05）。结论骨科手术麻醉中运用硬膜外麻醉相对于全身麻醉而言可以减少患者术后认知功能障碍的风险。

英文摘要：

Objective To find out the influence of general and intraspinal anesthesia on post operative cognitive funation. Methods By using Meta-analysis, literature was searched in PubMed, Embase, Cochrane library, Ovid database, CNKI, Wanfang database and VIP database from inception to October 31 2014 to find randomized controlled trials about the incident of cognitive dysfunction after general or imranspinal anesthesia in orthopedic surgery. Analysis was performed by Revman 5.3. Results There was no significant different between the incident of post-operative cognitive dysfunction after general or spinal anesthesia in orthopedic surgery （RR=1.83, 95%CI 0.72-4.65, P=0.20）. The risk of post operative cognitive dysfunction after epidural anesthesia was significant lower than that after general anesthesia （RR=l.37, 95%CI 1.00-1.88, P=0.05）. Conclusion Using epidural anesthesia in orthopedic can lower the risk of post operative cognitive dysfunction than general anesthesia.