腰硬联合麻醉对患者下肢骨关节手术围术期凝血功能的影响  

The effectsof coagulation function inperioperative period on patients undergone Lower limb joint operation withcombined spinal and epidural anesthesia

作　　者：王华 叶慧仪 李云龙 梁亚力 钟克宣 杨耿华 刘发全 

机构地区：[1]广东省东莞市大岭山医院麻醉科,523820 [2]广东省东莞市大岭山医院外科,523820 [3]广东省东莞市大岭山医院检验科,523820

出　　处：《中国实用医药》2012年第24期1-4,共4页China Practical Medicine

基　　金：东莞市科技计划医疗卫生类科研一般项目(项目编号:201210515042198)

摘　　要：目的探讨腰硬联合麻醉对患者下肢骨关节手术围术期凝血功能的影响。方法选择择期行下肢骨关节手术的患者90例,ASAⅠ-Ⅲ级,随机分为腰硬联合麻醉组(CSEA组)、硬膜外麻醉组(EA组)和全麻组(GA组),每组30例。分别于麻醉前(T0)、麻醉后6h(T1)、术后24h(T2)采静脉血行凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、凝血酶时间(TT)、纤维蛋白原(Fbg)等凝血功能检测。结果三组组内比较PT、TT值T1、T2较麻醉前延长(P<0.05);CSEA组、EA组组内比较APTT值T1、T2较麻醉前延长(P<0.05),GA组组内比较APTT值各时点较麻醉前无显著差异,无统计学意义(P>0.05);CSEA组、EA组组内比较Fbg值T1、T2较麻醉前降低(P<0.05);GA组组内比较Fbg值各时点较麻醉前无显著差异,无统计学意义(P>0.05);上述各项指标麻醉后各时间点组间比较无显著差异,无统计学意义(P>0.05)。结论腰硬联合麻醉、硬膜外麻醉能有效的预防患者下肢手术围术期血液高凝状态,有利于减少围术期血栓性并发症的发生;腰硬联合麻醉是下肢骨关节手术首选的麻醉方法。Objective Comparison the a effectsof coagulation function inperioperative period on patients undergone Lower limb joint operation withcombined spinal and epidural anesthesia. Methods 90 cases of under-going selective lower limb joint operation （ASAI-Ⅲ grade） were randomly divided into three groups： group of combined spinal and epidural anesthesia for 30 cases （ CSEA group）, group of epidural anesthesia for 30 cases （ EA group） and group of general anesthesiafor 30 cases （GA group）. Parameters of coagulation function including in prothrombin time （PT）, activated partial thremboplastin time （ APTY）, thrombin time （TY） and fibrinogen （Fbg） were detected before anesthesia （TO ）, 6 hours after anesthesia （T1 ） and 24 hours after anesthesia （T2） by with-drawing blood from patient＇s veins. Results Within every group time of PT or TT at T1 and T2 time points was longer than from that at To time point （P 〈 0. 05 ）. Within CSEA group and EA group time of AFTT at T1 and T2 time points was longer than from that at TO time point（ P 〈0. 05） ,but Within GA group time of AFTT at T1 and T2 time points was not significantly different from that at TO time point in H group （P 〉 0. 05 ）. Within CSEA group and EA group content of Fbg at T1 and T2 time points was longer than from that at To time point （ P 〈0. 05） ,but Within GA group content of Fbg at T1 and T2 time points was not significantly different from that at TO time point in H group （P 〉 0. 05）. Every parameters of coagulation function with comparison among groups at T1 and T2 time points was not significantly different from that at TO time point in H group （P 〉 0. 05）. Conclusion Combined spinal and epidural anesthesia andepidural anesthesia will more effectively prevent rejection hepercoagulabale state on patients of Lower limb joint operation, reduce thrombotic complicationin perioperative period. Combined spinal and epidural anesthesia is the first choice method of anesthesia for Lower li

关 键 词：腰硬联合麻醉 下肢骨关节手术 围术期 凝血功能 影响 

分 类 号：R614[医药卫生—麻醉学]