CAJ | 학술논문

目的：对比观察全麻与腰硬联合麻醉在老年股骨颈骨折手术的效果。方法将2013年1月至2015年6月行股骨颈骨手术的124例患者，随机分成实验组和对照组，每组62例。对照组患者采取全身麻醉，实验组患者采取腰硬联合麻醉。观察两组患者：①术中不良反应：高血压、低血压、心动过缓发生率、缺氧发生率；②手术的麻醉效果；③肌肉松弛效果；④观察麻醉起效时间；⑤镇痛效果；⑥术后不良反应发生情况；⑦患者满意度。结果①实验组患者的高血压、低血压发生率明显低于对照组，差异具有统计学意义（ P ﹤0.05）；两组心动过缓、缺氧发生率比较，差异无统计学意义（ P ﹥0.05）。②实验组实麻醉总优良率高于对照组，差异有统计学意义（98.4％ vs.85.5％，P ﹤0.05）。③实验组手术中肌肉松弛效果总满意率高于对照组，差异有统计学意义（98.4％ vs.83.9％，P ﹤0.05）。④实验组麻醉起效时间明显短于对照组（ P ﹤0.05）。⑤实验组术后镇痛效果 VAS 评分明显小于对照组（ P ﹤0.05）。⑥实验组患者头晕嗜睡、恶心呕吐、肺部感染等发生率明显低于对照组（ P ﹤0.05）。⑦两组患者对手术的满意度比较差异无明显统计学意义（ P ﹥0.05）。结论与全身麻醉相比，在老年股骨颈骨折手术实施过程中应用腰硬联合麻醉，起效更快，镇痛效果更好，不良反应发生率更低，值得临床上推广应用。
목적：대비관찰전마여요경연합마취재노년고골경골절수술적효과。방법장2013년1월지2015년6월행고골경골수술적124례환자，수궤분성실험조화대조조，매조62례。대조조환자채취전신마취，실험조환자채취요경연합마취。관찰량조환자：①술중불량반응：고혈압、저혈압、심동과완발생솔、결양발생솔；②수술적마취효과；③기육송이효과；④관찰마취기효시간；⑤진통효과；⑥술후불량반응발생정황；⑦환자만의도。결과①실험조환자적고혈압、저혈압발생솔명현저우대조조，차이구유통계학의의（ P ﹤0.05）；량조심동과완、결양발생솔비교，차이무통계학의의（ P ﹥0.05）。②실험조실마취총우량솔고우대조조，차이유통계학의의（98.4％ vs.85.5％，P ﹤0.05）。③실험조수술중기육송이효과총만의솔고우대조조，차이유통계학의의（98.4％ vs.83.9％，P ﹤0.05）。④실험조마취기효시간명현단우대조조（ P ﹤0.05）。⑤실험조술후진통효과 VAS 평분명현소우대조조（ P ﹤0.05）。⑥실험조환자두훈기수、악심구토、폐부감염등발생솔명현저우대조조（ P ﹤0.05）。⑦량조환자대수술적만의도비교차이무명현통계학의의（ P ﹥0.05）。결론여전신마취상비，재노년고골경골절수술실시과정중응용요경연합마취，기효경쾌，진통효과경호，불량반응발생솔경저，치득림상상추엄응용。
Objective To study the different anesthetic methods on elderly patients with femoral neck fracture. Methods From January 2013 to June 2015 to the femoral neck bone surgery,124 patients were randomly divided into experimental group and the control group,62 cases in each group. Taken general anesthesia during the surgery,the control group,experimental group take the waist hard joint anesthesia. Indicators were observed,including ① intraoperative adverse reactions:hypertension,hypotension,bradycardia incidence,the incidence of hypoxia;② an-esthesia surgery;③ muscle relaxant effect;④ observe the onset time of anesthesia;⑤ analgesia ;⑥postoperative adverse events;⑦ patient sat-isfaction. Results ① The experimental group of patients with hypertension,the incidence of hypotension was significantly lower than the control group,the difference was statistically significant( P ﹤ 0. 05). The difference was not statistically significant in bradycardia,hypoxia incidence( P ﹥ 0. 05 ). ② The total anesthesia real good rate in experimental group was higher,the difference was statistically significant(98. 4% vs. 85. 5% ,P ﹤ 0. 05). ③The experimental surgery muscle relaxation effect overall satisfaction rate was higher,the difference was statistically significant (98. 4% vs. 83. 9% ,P ﹤ 0. 05). ④ The onset time of anesthesia in the experimental group was significantly shorter than that of the control group ( P ﹤ 0. 05). ⑤The postoperative analgesia VAS scores of experimental group were significantly lower than the control group( P ﹤ 0. 05). ⑥The experimental group were dizziness,drowsiness,nausea,vomiting,pulmonary infection. The rate was significantly lower than the control group ( P ﹤ 0. 05). ⑦ The difference in satisfaction with the surgery two groups of patient was not statistically significant( P ﹥ 0. 05). Conclusion The waist hard joint anesthesia is better than general anesthesia. This method is suitable for the implementation of the elderly femoral neck fracture surgery,it have the lower incidence of adverse,analgesic effect is better. This method is worthy of clinical popularization and application.