中外医疗
中外醫療
중외의료
China Foreign Medical Treatment
2015年
27期
11-12,19
,共3页
腰麻-硬膜外麻醉%超高龄骨折%手术
腰痳-硬膜外痳醉%超高齡骨摺%手術
요마-경막외마취%초고령골절%수술
Combined spinal-epidural analgesia%Over-aged patients with fracture%Operation
目的 探讨腰麻-硬膜外麻醉在超高龄患者骨折手术中的应用效果.方法 随机抽取该院2013年5月-2014年5月骨科收治的72例超高龄骨折患者的临床资料. 患者随机分为实验组和对照组,每组36例. 实验组患者采取腰麻-硬膜外麻醉,对照组患者采取持续硬膜外麻醉.比较两组患者麻醉前、麻醉后、5 min、10 min、30 min、60 min时HR、SBP、DBP、SpO2水平变化情况、是否出现呼吸抑制或头痛难忍等不良反应以及VAS评分情况.结果 所有患者麻醉后5 min HR显著升高、SBP显著下降,与麻醉前比较,差异具有统计学意义(P<0.05);其余各时间点HR、SBP、DBP以及SpO2与麻醉前比较,水平均无明显变化,差异无统计学意义(P>0.05);无1例患者出现头痛难忍或呼吸抑制等不良反应,VAS评分均不超过4分. 实验组患者平均麻醉起效时间、阻滞完善时间、硬膜外用药量均优于对照组,差异有统计学意义(P<0.05). 结论 腰麻-硬膜外麻醉对超高龄患者骨折手术中血流动力学各项指标影响较小,患者耐受性好,临床应用安全性较高.
目的 探討腰痳-硬膜外痳醉在超高齡患者骨摺手術中的應用效果.方法 隨機抽取該院2013年5月-2014年5月骨科收治的72例超高齡骨摺患者的臨床資料. 患者隨機分為實驗組和對照組,每組36例. 實驗組患者採取腰痳-硬膜外痳醉,對照組患者採取持續硬膜外痳醉.比較兩組患者痳醉前、痳醉後、5 min、10 min、30 min、60 min時HR、SBP、DBP、SpO2水平變化情況、是否齣現呼吸抑製或頭痛難忍等不良反應以及VAS評分情況.結果 所有患者痳醉後5 min HR顯著升高、SBP顯著下降,與痳醉前比較,差異具有統計學意義(P<0.05);其餘各時間點HR、SBP、DBP以及SpO2與痳醉前比較,水平均無明顯變化,差異無統計學意義(P>0.05);無1例患者齣現頭痛難忍或呼吸抑製等不良反應,VAS評分均不超過4分. 實驗組患者平均痳醉起效時間、阻滯完善時間、硬膜外用藥量均優于對照組,差異有統計學意義(P<0.05). 結論 腰痳-硬膜外痳醉對超高齡患者骨摺手術中血流動力學各項指標影響較小,患者耐受性好,臨床應用安全性較高.
목적 탐토요마-경막외마취재초고령환자골절수술중적응용효과.방법 수궤추취해원2013년5월-2014년5월골과수치적72례초고령골절환자적림상자료. 환자수궤분위실험조화대조조,매조36례. 실험조환자채취요마-경막외마취,대조조환자채취지속경막외마취.비교량조환자마취전、마취후、5 min、10 min、30 min、60 min시HR、SBP、DBP、SpO2수평변화정황、시부출현호흡억제혹두통난인등불량반응이급VAS평분정황.결과 소유환자마취후5 min HR현저승고、SBP현저하강,여마취전비교,차이구유통계학의의(P<0.05);기여각시간점HR、SBP、DBP이급SpO2여마취전비교,수평균무명현변화,차이무통계학의의(P>0.05);무1례환자출현두통난인혹호흡억제등불량반응,VAS평분균불초과4분. 실험조환자평균마취기효시간、조체완선시간、경막외용약량균우우대조조,차이유통계학의의(P<0.05). 결론 요마-경막외마취대초고령환자골절수술중혈류동역학각항지표영향교소,환자내수성호,림상응용안전성교고.
Objective To explore the effect of combined spinal-epidural analgesia applied to over-aged patients with fracture. Methods The clinical data of 72 over-aged cases with fracture admitted in the Department of Orthopedics of our hospital from May 2013 to May 2014 were selected. The patients were randomly divided into the experimental group and the control group with 36 cases in each. Patients in the experimental group were treated by combined spinal-epidural analgesia, and those in the control group were treated by continuous epidural anesthesia. The changes in HR, SBP, DBP and SpO2 before anesthesia and 5min, 10min, 30min, 60min after anesthesia, incidence of respiratory depression or severe headache beyond suffering and other adverse reactions, and VAS were compared between the two groups. Results Compared with before anesthesia, HR increased while SBP decreased significantly in all the patients 5min after anesthesia (P<0.05). No statistically significant differences were found in the levels of HR, SBP, DBP and SpO2 10min, 30min, 60min after anesthesia compared with before anesthesia(P>0.05). No patients had severe headache beyond suffering or respiratory depression. And all the patients had VAS no more than 4 points. Compared with the control group, the experimental group had much earlier mean anesthetic onset time, shorter mean time for perfectly blocking, less mean epidural dosage with statistically significant differences(P<0.05). Conclusion For over-aged patients with fracture, com-bined spinal-epidural analgesia has small effect on the indexes of haemodynamics with good tolerance and high safety.
