不同麻醉方法对骨科手术患者深静脉血栓形成的影响  

Effect of Different Anesthesia on Deep Venous Thrombosis after Orthopedic Surgery

作　　者：姚杰[1] 孟尽海[2] 王文娟[1] 刘斐[1] 吴燕[1] 王春生[1] 

机构地区：[1]宁夏医科大学,银川750004 [2]宁夏医科大学总医院麻醉科,银川750004

出　　处：《宁夏医科大学学报》2013年第1期29-31,36,共4页Journal of Ningxia Medical University

摘　　要：目的研究不同麻醉方法对深静脉血栓(DVT)的影响。方法以4892例骨科住院患者病例资料为研究对象进行回顾性分析,比较全身麻醉组、椎管内麻醉组、区域阻滞组DVT的发生率。结果 4892例患者中204例发生DVT,总发生率为4.17%,全麻组DVT的发生率高于椎管内组、区域阻滞组和未行麻醉组(P<0.01);椎管内组DVT的发生率高于区域阻滞组(P<0.05)。区域阻滞组和未行麻醉组DVT的发生率相当,差异无统计学意义(P>0.05)。全身麻醉组患者术后白细胞、中性粒细胞、单核细胞计数高于椎管内麻醉组和区域阻滞麻醉组(P<0.05)。结论全身麻醉后患者深静脉血栓的发生率最高,椎管内麻醉次之,区域阻滞麻醉和未行麻醉者相当。全身麻醉较椎管内麻醉、区域阻滞麻醉和未行麻醉患者炎症细胞数升高。Objective To investigate the effects of different anesthesia on deep venous thrombosis （DVT） after orthopedic surgery. Methods Charts from consecutive patients who underwent orthopedic surgery from Janu-ary 1, 2008, to December 31, 2010, at a large Chinese teaching hospital were reviewed using standardized case report forms. The incidence of DVT after orthopedic surgery in general anesthesia, spinal - epidural anesthesia and regional block anesthesia were compared. Results This investigation included 4892 patients and 204 patients developed DVT （incidence = 4.17% ）. The incidence of DVT in the group of general anesthesiawas higher than in those of spinal -epidural anesthesia, regional block anesthesia and no anesthesia （P 〈 0.01 ）. The incidence of DVT in the group of spinal - epidural anesthesia was higher than in that of regionalblock anesthesia （ P 〈 0.05 ）. There was no statistically significant in the incidence of DVT between spinal - epidural anesthesia and no anesthesia （P 〉 0.05 ）. The counts of white blood cell, neutrophil and monocyte ofthe group after general anesthesia were higher than those of spinat - epidural anesthesia and regional block anesthesia （P 〈 0.05 ）. Conclusion The incidence of DVT in the group of general anesthesia is higher than spi-nal - epidural anesthesia. In addition, regional block anesthesia and no anesthesia were similar. Inflammatory cell in the group of general anesthesia are higher than that in group of spinal - epidural anesthesia, regionalblock anesthesia and no anesthesia.

关 键 词：全身麻醉 椎管内麻醉 区域阻滞麻醉 深静脉血栓 

分 类 号：R614[医药卫生—麻醉学]