CAJ | 학술논문

目的：比较喉罩通气全麻与腰硬联合麻醉在老年股骨颈骨折内固定术麻醉中的效果。方法将88例老年股骨颈骨折内固定术患者按照随机数字法分为A组和B组，A组喉罩通气全麻，B组腰硬联合麻醉，观察两组麻醉效果。结果 A组的低血压发生率、并发症发生率均低于B组(P<0.05)；A组和B组患者麻醉6 h后的VAS评分均较麻醉前有明显降低，差异有统计学意义(P<0.05)。麻醉5 min后A组MAP和HR稍低于麻醉前，但随后其值逐渐恢复麻醉前水平。麻醉5 min和内固定时以及手术结束时B组MAP和HR与A组数据比较，差异有统计学意义(P<0.06)。结论老年股骨颈骨折内固定术中应用喉罩通气全麻效果明显优于腰硬联合麻醉效果，能够有效维持患者的血气指标稳定，麻醉效果优越，值得临床中应用与推广。
목적：비교후조통기전마여요경연합마취재노년고골경골절내고정술마취중적효과。방법장88례노년고골경골절내고정술환자안조수궤수자법분위A조화B조，A조후조통기전마，B조요경연합마취，관찰량조마취효과。결과 A조적저혈압발생솔、병발증발생솔균저우B조(P<0.05)；A조화B조환자마취6 h후적VAS평분균교마취전유명현강저，차이유통계학의의(P<0.05)。마취5 min후A조MAP화HR초저우마취전，단수후기치축점회복마취전수평。마취5 min화내고정시이급수술결속시B조MAP화HR여A조수거비교，차이유통계학의의(P<0.06)。결론노년고골경골절내고정술중응용후조통기전마효과명현우우요경연합마취효과，능구유효유지환자적혈기지표은정，마취효과우월，치득림상중응용여추엄。
Objective To compare the anesthetic effect of general anesthesia of laryngeal mask airway and combined spinal and epidural anesthesia in internal fixation of femoral neck fracture for elderly patients. Methods A total of 88 patients receiving internal fixation of femoral neck fracture were allocated to group A and group B based on random numbers. The group A received general anesthesia of laryngeal mask, and the group B received combined spinal and epidural anesthesia. The anesthetic effects of the two groups were observed. Results Incidence of low blood pressure and complications in the group A were both lower than those in the group B (P<0.05); Scores of VAS in 6 hours after the anesthesia in both groups significantly reduced compared to the scores before the anesthesia, and the differences between the two groups were statistically significant (P<0.05). MAP and HR in the group A in 5 min after the anesthesia were slightly lower than those before the anesthesia, but they gradually resumed to the level before the anesthesia as time went by. The differences of MAP and HR between the two groups in 5 min after the anesthesia, during internal fixation and after the surgery were all statistically significant (P<0.05). Conclusion The effects of general anesthesia of laryngeal mask airway in internal fixation of femoral neck fracture for elderly patients are significantly better than that of combined spinal and epidural anesthesia. The general anesthesia helps effectively maintain patients'blood gas index with a significantly anesthetic effect, which is worthy of clinical application and promotion.