侧入法腰硬联合麻醉在高龄患者下肢手术中的应用效果  

Application effect of combined spinal-epidural anesthesia by lateral approach method in elderly patients undergoing lower limb surgery

作　　者：肖遥 常青 张真真 

机构地区：[1]河南省骨科医院麻醉科,郑州471000

出　　处：《中国当代医药》2016年第23期102-104,共3页China Modern Medicine

摘　　要：目的探讨侧入法腰硬联合麻醉在高龄患者下肢手术中的应用效果。方法选取2015年1~12月在我院行下肢手术的80例75岁以上高龄患者作为研究对象,随机分成A组和B组,各40例。A组采用侧入法,B组采用直入法。比较两组的穿刺时间、穿刺次数、成功率、麻醉起效时间、穿刺损伤与相关并发症的发生率。结果 A组的穿刺时间短于B组,差异有统计学意义（P〈0.01）。A组的穿刺成功率高于B组,差异有统计学意义（P〈0.01）。A组的一次、二次、三次穿刺成功率显著高于B组,差异有统计学意义（P〈0.01）。A组的患侧先于健侧起效例数所占比例显著高于B组,差异有统计学意义（P〈0.01）。A组的穿刺后腰背痛发生率低于B组,疼痛持续时间短于B组,差异有统计学意义（P〈0.05）。结论侧入法腰硬联合麻醉穿刺在高龄患者中的应用效果显著,穿刺时间短,穿刺成功率高,穿刺后腰背痛发生率低,值得临床推广应用。Objective To explore the application effect of combined spinal-epidural anesthesia by lateral approach method in elderly patients undergoing lower limb surgery.Methods 80 elderly patients over 75 years old undergoing lower limb surgery from January to December in 2015 in our hospital were selected and randomly divided into group A and group B,40 cases in each group.Group A was given lateral approach method,group B was given straight puncture method.The time of puncture,puncture times,the success rate,the onset time of anesthesia,the incidence rate of puncture injury and related complications in the two groups was compared respectively.Results The puncture time of group A was shorter than that of group B,with significant difference（P〈0.01）.The puncture success rate of group A was higher than that of group B,with significant difference（P〈0.01）.The success rate of one time,two times and three times in group A was higher than that in group B,with significant difference（P〈0.01）.The proportion of the onset number of affected side ahead of the healthy side in group A was higher than that in group B,with significant difference（P〈0.01）.The incidence rate of low back pain after puncture in group A was lower than that in group B,and the duration of pain in group A was shorter than that of group B,with significant difference（P〈0.05）.Conclusion The application effect of combined spinal-epidural anesthesia by lateral approach method in elderly patients is significant,the puncture time is short,the puncture success rate is high,and the incidence rate of low back pain after puncture is low,it is worthy of clinical promotion and application.

关 键 词：侧入法 高龄 腰硬联合麻醉 下肢手术 

分 类 号：R614[医药卫生—麻醉学]