中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2013年
6期
31-33
,共3页
髋关节置换术%腰-硬联合麻醉%全身麻醉%老年人
髖關節置換術%腰-硬聯閤痳醉%全身痳醉%老年人
관관절치환술%요-경연합마취%전신마취%노년인
Hip replacement surgery%Spinal-epidural anesthesia%Anesthesia%Elderly
目的 比较腰-硬联合麻醉和气管插管全身麻醉在髋关节置换术中的应用效果.方法 选取需行髋关节置换术的老年患者共36例,随机分成腰-硬联合麻醉组(A组)和全身麻醉组(B组),每组各18例.监测并记录两组患者围术期的心率(HR)、血压(BP)及SpO2的变化,观察记录精神状况、手术时间、下床锻炼时间和出院时间.结果 两组患者麻醉后血压均显著低于麻醉前(P＜0.01),组间比较差异无统计学意义(P＞0.05)；所有患者术中于注入骨水泥即刻的BP明显下降(P＜0.01)；B组低血压发生率为44.4％ (8/18),显著高于A组的27.8％(5/18),P＜0.05;B组插管拔管的BP及HR较A组患者明显升高(P＜0.05)；两组手术时间、下床锻炼时间和出院时间比较差异无统计学意义；A、B组术后神经、精神症状发生率分剐为50.0％和38.9％,两组比较差异无统计学意义(P＜0.05).结论 两种麻醉方式均可应用于髋关节置换术,注入水泥前后是监测加强生命体征的关键点,且应做好抢救准备；腰-硬联合麻醉中低血压发生率较全身麻醉低,更为安全.
目的 比較腰-硬聯閤痳醉和氣管插管全身痳醉在髖關節置換術中的應用效果.方法 選取需行髖關節置換術的老年患者共36例,隨機分成腰-硬聯閤痳醉組(A組)和全身痳醉組(B組),每組各18例.鑑測併記錄兩組患者圍術期的心率(HR)、血壓(BP)及SpO2的變化,觀察記錄精神狀況、手術時間、下床鍛煉時間和齣院時間.結果 兩組患者痳醉後血壓均顯著低于痳醉前(P＜0.01),組間比較差異無統計學意義(P＞0.05)；所有患者術中于註入骨水泥即刻的BP明顯下降(P＜0.01)；B組低血壓髮生率為44.4％ (8/18),顯著高于A組的27.8％(5/18),P＜0.05;B組插管拔管的BP及HR較A組患者明顯升高(P＜0.05)；兩組手術時間、下床鍛煉時間和齣院時間比較差異無統計學意義；A、B組術後神經、精神癥狀髮生率分剮為50.0％和38.9％,兩組比較差異無統計學意義(P＜0.05).結論 兩種痳醉方式均可應用于髖關節置換術,註入水泥前後是鑑測加彊生命體徵的關鍵點,且應做好搶救準備；腰-硬聯閤痳醉中低血壓髮生率較全身痳醉低,更為安全.
목적 비교요-경연합마취화기관삽관전신마취재관관절치환술중적응용효과.방법 선취수행관관절치환술적노년환자공36례,수궤분성요-경연합마취조(A조)화전신마취조(B조),매조각18례.감측병기록량조환자위술기적심솔(HR)、혈압(BP)급SpO2적변화,관찰기록정신상황、수술시간、하상단련시간화출원시간.결과 량조환자마취후혈압균현저저우마취전(P＜0.01),조간비교차이무통계학의의(P＞0.05)；소유환자술중우주입골수니즉각적BP명현하강(P＜0.01)；B조저혈압발생솔위44.4％ (8/18),현저고우A조적27.8％(5/18),P＜0.05;B조삽관발관적BP급HR교A조환자명현승고(P＜0.05)；량조수술시간、하상단련시간화출원시간비교차이무통계학의의；A、B조술후신경、정신증상발생솔분과위50.0％화38.9％,량조비교차이무통계학의의(P＜0.05).결론 량충마취방식균가응용우관관절치환술,주입수니전후시감측가강생명체정적관건점,차응주호창구준비；요-경연합마취중저혈압발생솔교전신마취저,경위안전.
Objective To compare the effect of combined spinal epidural anesthesia and general anesthesia on total hip replacement.Methods Thirty-six cases were randomly divided into the spinal-epidural anesthesia group(group A) and general anesthesia group(group B),and there were 18 cases in each groups.Both groups of patients' perioperative heart rate(HR),blood pressure(BP),SpO2,mental condition,operative time,time of exercise out of bed and length of hospital stay were recorded.Results After anesthesia,both groups' BP were significantly lower than before anesthesia (P ＜ 0.01),but there had no significant difference between the two groups (P ＞ 0.05).In all patients,the BP decreased significantly just after injection of bone cement (P ＜ 0.01).Hypotension incidence in group B was 44.4％ (8/18),significantly higher than that in group A(27.8％,5/18) P ＜0.05.The BP and HR when extubating of tracheal intubation in group B was higher than that in group A (P ＜ 0.05).There was no significant difference in operative time,time of exercise out of bed and length of hospital stay between the two groups.The incidence of psychiatric symptoms of group A and group B were 50.0％ and 38.9％,the difference was not statistically significant.Conclusions Both anesthesias can be used in total hip arthroplasty.Besides,it's the key point that the moment when bone cement was injected,so getting ready to rescue is essential.However,hypotension incidence in combined spinal epidural anesthesia is lower than that in general anesthesia,which meant that combined spinal epidural anesthesia is more safe.
