中国临床新医学
中國臨床新醫學
중국림상신의학
Chinese Journal of New Clinical Medicine
2015年
10期
969-972
,共4页
不同比重液%老年人%髋部手术%单侧腰麻
不同比重液%老年人%髖部手術%單側腰痳
불동비중액%노년인%관부수술%단측요마
Different proportions of mixture%Elderly patients%Hip operation%Unilateral spinal anes-thesia
目的：观察不同比重液单侧腰麻在老年人髋部手术中的麻醉效果及并发症。方法将60例择期行髋部手术的老年患者随机分为两组：轻比重组（A组）30例（0.75％布比卡因与灭菌注射用水混合）；重比重组（ B组）30例（0.75％布比卡因与5％葡萄糖注射液混合）。两组均选择腰硬联合麻醉（ CSEA），混合液含布比卡因8～15 mg，推注速度0.1 ml／s，注药完毕后维持穿刺体位不变至麻醉平面固定。观察麻醉起效时间、阻滞完全时间、持续时间、血流动力学变化及不良反应发生率。结果两组患者术中麻醉效果均满意，A组麻醉起效时间及平面固定时间均较B组延长（P＜0.01），而维持时间较B组短（P＜0.01）。与A组相比，B组血流动力学波动较大，需要辅助使用血管活性药，差异有统计学意义（ P＜0.05）。结论轻比重与重比重单侧腰麻均可适用于老年髋部手术麻醉，但轻比重单侧腰麻的血流动力学更趋于稳定，更加安全可行。
目的：觀察不同比重液單側腰痳在老年人髖部手術中的痳醉效果及併髮癥。方法將60例擇期行髖部手術的老年患者隨機分為兩組：輕比重組（A組）30例（0.75％佈比卡因與滅菌註射用水混閤）；重比重組（ B組）30例（0.75％佈比卡因與5％葡萄糖註射液混閤）。兩組均選擇腰硬聯閤痳醉（ CSEA），混閤液含佈比卡因8～15 mg，推註速度0.1 ml／s，註藥完畢後維持穿刺體位不變至痳醉平麵固定。觀察痳醉起效時間、阻滯完全時間、持續時間、血流動力學變化及不良反應髮生率。結果兩組患者術中痳醉效果均滿意，A組痳醉起效時間及平麵固定時間均較B組延長（P＜0.01），而維持時間較B組短（P＜0.01）。與A組相比，B組血流動力學波動較大，需要輔助使用血管活性藥，差異有統計學意義（ P＜0.05）。結論輕比重與重比重單側腰痳均可適用于老年髖部手術痳醉，但輕比重單側腰痳的血流動力學更趨于穩定，更加安全可行。
목적：관찰불동비중액단측요마재노년인관부수술중적마취효과급병발증。방법장60례택기행관부수술적노년환자수궤분위량조：경비중조（A조）30례（0.75％포비잡인여멸균주사용수혼합）；중비중조（ B조）30례（0.75％포비잡인여5％포도당주사액혼합）。량조균선택요경연합마취（ CSEA），혼합액함포비잡인8～15 mg，추주속도0.1 ml／s，주약완필후유지천자체위불변지마취평면고정。관찰마취기효시간、조체완전시간、지속시간、혈류동역학변화급불량반응발생솔。결과량조환자술중마취효과균만의，A조마취기효시간급평면고정시간균교B조연장（P＜0.01），이유지시간교B조단（P＜0.01）。여A조상비，B조혈류동역학파동교대，수요보조사용혈관활성약，차이유통계학의의（ P＜0.05）。결론경비중여중비중단측요마균가괄용우노년관부수술마취，단경비중단측요마적혈류동역학경추우은정，경가안전가행。
Objective To study the anesthesia effect and its complications of the different proportions of uni-lateral spinal anesthesia in the elderly patients with hip operation.Methods Sixty elderly patients with hip operation were randomly divided into two groups,both of which were implemented by combined spinal epidural anesthesia.The hypobaric group(group A, n=30) was used 0.75% bupivacaine mixed with sterile water for injection.The hyper-baric(group B, n=30) was used 0.75%bupivacaine mixed with 5%glucose for injection.The two groups were a-dopted mixed liquor contained bupivacaine ranging from 8 to 15 mg and the speed of injection was 0.1 ml/s.In order to maintain the anesthesia plane, all the patients kept the same puncture position for a moments as before.The onset time of anesthesia, completely block time of anesthesia, time of duration, hemodynamic changes and the incidence of adverse reactions were observed in this study.Results All the patients satisfied with the anesthesia effect in the two groups.The onset time of anesthesia and the plane of the fixed time in group A were longer than those in group B. The time of duration in group A was shorter than that in group B.A severe hemodynamic fluctuation was found in group B, which needed to add vasoactive drugs.Conclusion Both of the proportions of specific gravity of unilateral spinal anesthesia is safe on hip operation for the elderly patients, but the hemodynamic of the light specific gravity of the unilateral spinal anesthesia is more stable and feasible.
