腰硬联合麻醉与硬膜外麻醉用于老年髋关节置换术的临床对比分析  

Analysis of Clinical Comparison of Combined Spinal-epidural Analgesia and Epidural Anesthesia in Senile Patients with Hip Joint Replacement

作　　者：秦国昕 QIN Guo-xin(Department of Anesthesia,Guangling District Hospital of TCM,Yangzhou,Jiangsu Province,225000 China)

机构地区：[1]扬州市广陵区中医院麻醉科,江苏扬州225000

出　　处：《中外医疗》2018年第8期92-93,96,共3页China & Foreign Medical Treatment

摘　　要：目的探讨老年髋关节置换术中腰硬联合麻醉与硬膜外麻醉的临床疗效。方法方便选取该院在2014年12月—2015年10月期间所收治的行髋关节置换术74例老年患者作为该次研究对象,按照麻醉方式的不同,将其分为研究组和对照组,每组37例,对照组采取硬膜外麻醉,研究组行腰硬联合麻醉,对比分析两组患者麻醉后5、10、30 min的MAP与心率,观察两组麻醉起效时间与VAS评分,并详细记录两组使用镇静药与血管活性药物的情况。结果研究组的麻醉起效平均时间(4.5±1.1)min显著短于对照组(10.2±3.4)min,研究组VAS评分(13.1±3.3)分低于对照组(18.9±4.5)分(t=9.720 4,6.322 2,P<0.05),且两组在镇静剂与升压药物使用方面差异有统计学意义(χ~2=5.232 3,5.0455,2.055 6,P<0.05)。结论老年髋关节置换术中采取腰硬联合麻醉后,手术的镇痛效果较好,考虑患者为老年,麻醉方式适合老年患者,值得应用。Objective To study the clinical curative effect of combined spinal-epidural analgesia and epidural anesthesia in senile patients with hip joint replacement.Methods 74 cases of senile patients with hip joint replacement admitted and treated in our hospital from December 2014 to October 2015 were convenient selected as the research objects and divided into two groups with 37 cases in each according to different anesthesia methods,the control group and the research group were respectively treated with epidural anesthesia and combined spinal-epidural analgesia,and the MAP,and heart rate at 5min,10min,and 30 min after anesthesia were compared between the two groups,and the anesthesia onset time and VAS score of the two groups were observed,and the sedatives usage and vasoactive agents of the two groups were recorded in detail.Results The average time of anesthesia onset in the research group was obviously shorter than that in the control group,[(10.2±3.4)min vs(4.5±1.1)min],and the VAS score in the research group was lower than that in the control group[(13.1±3.3)points vs(18.9±4.5)points],(t=9.720 4,6.322 2,P<0.05),and the differences in the sedatives usage and vasoactive agents between the two groups were obvious,with statistical significance(χ2=5.232 3,5.045 5,2.055 6,P<0.05).Conclusion The analgesic effect of combined spinal-epidural analgesia in senile patients with hip joint replacement is better,which is suitable for the senile patients,and it is worth application.

关 键 词：腰硬联合麻醉 硬膜外麻醉 髋关节置换术 

分 类 号：R4[医药卫生—临床医学]