CAJ | 학술논문

研究术毕硬膜外腔注入生理盐水对老年骨科病人术后早期运动、血压、饮食的影响。选择硬膜外麻醉下行骨科手术的老年患者200例，随机将患者分为A组（实验组）、B组（对照组），A组病人于手术终末期硬膜外腔分次注入生理盐水，注入生理盐水的量按术中使用的盐酸罗哌卡因的全部用量稀释至0.175%所需的生理盐水的量。B组术毕不注入生理盐水。记录患者术后0min （T0）、15min（T1）、30min（T2）、1h（T3）、2h(T4)、3h(T5)、4h(T6)、6h(T7)、8h(T8)的肢体运动、血压、饮食情况。A组T3以前全部能抬腿，肌力恢复正常，比B组早（P<0.05）。A组T0- T4时的SBP、DBP明显高于B组（P<0.05）,A组在T3以前饮水，T4后进流质无恶心呕吐等并发症，B组T6- T7后方能饮水进流质（P<0.05）。术毕从硬膜外腔注入生理盐水能使老年骨科病人运动神经麻痹迅速消退，使病人早期活动健侧肢体，减少病人心理负担，预防下肢血栓的形成。早期饮水进食，促进水电解质酸碱的平衡，减少静脉补液量，维持血压稳定，防止低血压的发生，减少心脑血管意外等并发症的发生。
연구술필경막외강주입생리염수대노년골과병인술후조기운동、혈압、음식적영향。선택경막외마취하행골과수술적노년환자200례，수궤장환자분위A조（실험조）、B조（대조조），A조병인우수술종말기경막외강분차주입생리염수，주입생리염수적량안술중사용적염산라고잡인적전부용량희석지0.175%소수적생리염수적량。B조술필불주입생리염수。기록환자술후0min （T0）、15min（T1）、30min（T2）、1h（T3）、2h(T4)、3h(T5)、4h(T6)、6h(T7)、8h(T8)적지체운동、혈압、음식정황。A조T3이전전부능태퇴，기력회복정상，비B조조（P<0.05）。A조T0- T4시적SBP、DBP명현고우B조（P<0.05）,A조재T3이전음수，T4후진류질무악심구토등병발증，B조T6- T7후방능음수진류질（P<0.05）。술필종경막외강주입생리염수능사노년골과병인운동신경마비신속소퇴，사병인조기활동건측지체，감소병인심리부담，예방하지혈전적형성。조기음수진식，촉진수전해질산감적평형，감소정맥보액량，유지혈압은정，방지저혈압적발생，감소심뇌혈관의외등병발증적발생。
To research the technique after epidural cavity injection of physiological saline for geriatric orthopaedic patients early postoperative exercise, blood pressure, the influence of the diet. Choose epidural anesthesia downlink orthopedic surgery of 200 cases of elderly patients and patients randomly divided into group A (experimental group) and group B (control group), A group of patients in surgical end- stage epidural cavity inject physiological saline by several times, the amount of injection of saline solution according to all the diluted to 0.175%for the amount of normal saline. Do not inject physiological saline with group B. Record patients' postoperative 0 min (T0), 15 min (T1), 30 min (T2), 1 h(T3), 2 h (T4), 3 h (T5), 4 h (T6) ,6h(T7 has), 8 h (T8), body movement, blood pressure and diet. Group A T3 before all can leg lifts before T3, muscle strength back to normal, earlier than group B (P<0.05). T0- T4 of SBP, DBP, group A is significantly higher than group B(P<0.05), group A drinking water before T3, eating liquid without complications such as nausea and vomiting after T4, T6, T7 has rear can drinking water into liquid group B(P<0.05). Finish operation from epidural cavity injection of physiological saline can make old age sports nerve palsy orthopedic patients quickly faded, make patient early activity in the contralateral limbs, reduce patient psychological burden, to prevent the formation of thrombosis of lower limbs. Early water feeding, promote water electrolyte acid- base balance, decrease the amount of intravenous rehydration, stable blood pressure, prevent the occurrence of low blood pressure, reduce the occurrence of complications such as heart cerebrovascular accident.