全麻与腰硬麻醉用于髋关节置换术的临床效果  

Clinical effect of general anesthesia combined with spinal and epidural anesthesia in total hip arthroplasty

作　　者：尹青梅[1] 吕建辉[2] 

机构地区：[1]烟台市莱阳中心医院麻醉科,265200 [2]烟台市莱阳中心医院肿瘤科,265200

出　　处：《国际医药卫生导报》2016年第24期3784-3786,共3页International Medicine and Health Guidance News

摘　　要：目的探讨在髋关节置管手术中应用全麻与腰硬联合麻醉的效果及推广价值。方法回顾性分析2013年3月至2015年3月在本院手术治疗的78例股骨颈骨折患者临床资料，均接受微创髋关节置换手术，根据麻醉方式不同分为全麻组和腰硬联合组，比较两组麻醉过程中血压、血流动力学、镇痛效果及不良反应等情况。结果两组SBP、DBP和HR在T1、T2、T3时呈现整体下降，HR水平整体上升趋势，但腰硬联合组变化幅度小于全麻组（P〈0．05）。腰硬联合组麻醉用药量、麻醉起效时间及阻滞完全时间均少于全麻组（P〈0．05）。两组VAS评分比较差异无统计学意义，但腰硬联合组不良反应发生率均明显低于全麻组（P〈0．05），比较差异具有统计学意义。结论对于行髋关节置换手术患者来说，全麻与腰硬联合麻醉方法在麻醉效果、镇痛效果等方面并无太大的差异，不过腰硬联合麻醉引起的不良反应少，更利于术后恢复，适合作为首选麻醉方式。Objective To investigate the effect of general anesthesia combined with spinal and epidural anesthesia in total hip arthroplasty. Methods The clinical data of 78 patients with femoral neck fracture surgically treated at our hospital from March, 2013 to March, 2015 were retrospectively analyzed. All the patients underwent minimally invasive hip replacement surgery. According to different anesthesia methods, they were divided into a general anesthesia group and an epidural group. The blood pressure during anesthesia, hemodynamic indexes, analgesic effect, and adverse reactions were compared between these two groups. Results The SBP and DBP decreased and the HR increased at T1, T2, and T3 in both groups but more in the general anesthesia group than in the epidural group （P 〈0.05）. The anesthesia drug dosage was lower and the onset time of anesthesia and complete blocked time were shorter in the epidural group than in the general anesthesia group （ P〈0.05 ） . There was no statistical difference in VAS between these two groups. The incidence of adverse reactions was lower in the epidural group than in the general anesthesia group （P〈0.05） . Conclusions For patients undertaking hip joint replacement surgery, general anesthesia is as anestheticly and analgesicly effective as epidural anesthesia, but epidural anesthesia causes fewer adverse reactions and is better for postoperative recovery, so it is the first choice for anesthesia.

关 键 词：全麻 腰硬联合麻醉 髋关节置换 股骨颈骨折 效果 

分 类 号：R687.4[医药卫生—骨科学]