围手术期伴合并症的75岁以上老年人的麻醉处理及安全性分析  

Perioperative Anesthesia Management and Safety Analysis for People Over 75 Years of age with Complications

作　　者：王襄兵 WANG Xiangbing(Chinese Medicine Hospital of Zigui County,Yichang,Hubei 443600,China)

机构地区：[1]湖北省秭归县中医院,湖北宜昌443600

出　　处：《大医生》2020年第15期33-35,共3页Doctor

摘　　要：目的分析全身麻醉辅助连续硬膜外麻醉在伴合并症的75岁以上老年人的麻醉效果及对降低麻黄素和(或)多巴胺使用率的临床价值。方法选取2018年3月至2019年3月湖北省秭归县中医院伴合并症的75岁以上老年患者84例为研究对象。按麻醉方法分为两组:连续硬膜外麻醉组(42例),硬膜+全身麻醉组(42例)。探析两组患者麻黄素和(或)多巴胺使用率、麻醉前后平均心率水平值、收缩压(SBP)水平值、舒张压(DBP)水平值。结果硬膜+全身麻醉组患者皮肤麻黄素和(或)多巴胺使用率为4.76%,明显低于连续硬膜外麻醉组的21.43%,差异有统计学意义(P<0.05)。麻醉后,硬膜+全身麻醉组平均心率水平值,SBP水平值,DBP水平值,相比麻醉前比较差异无统计学意义(P>0.05),且明显高于连续硬膜外麻醉组(P<0.05)。结论相比单纯接受连续硬膜外麻醉而言,全身麻醉辅助连续硬膜外麻醉在伴合并症的75岁以上老年人治疗中的麻醉效果更加显著,且能够降低麻黄素和(或)多巴胺使用率。Objective To analyze the anesthetic effect of general anesthesia assisted continuous epidural anesthesia in the elderly over 75 years of age with complications and its clinical value in reducing the utilization rate of ephedrine and/or dopamine.Methods From March 2018 to March 2019,84 elderly patients over 75 years of age from Chinese Medicine Hospital of Zigui County were selected as the subjects.Continuous epidural anesthesia in 42 patients,Patients in the epidural general anesthesia group(42 cases)received general anesthesia assisted by continuous epidural anesthesia.To explore the utilization rate of ephedrine and/or dopamine and mean heart rate before and after anesthesia value,systolic blood pressure(SBP)level value,diastolic blood pressure(DBP)level value.Results The utilization rate of ephedrine and/or dopamine in the dural general anesthesia group was 4.76%,significantly lower than 21.43%in the continuous epidural anesthesia group,difference was statistically significant(P>0.05).After anesthesia,mean heart rate,in dural general anesthesia group SBP level,DBP level and compared with pre-anesthesia,there was no significant difference in comparison(P>0.05),and significantly higher than that in the continuous epidural anesthesia group(P<0.05).Conclusion Compared with continuous epidural anesthesia alone,general anesthesia assisted continuous epidural anesthesia is more effective in the treatment of people over 75 years of age with complications,and can reduce the utilization rate of ephedrine and/or dopamine.

关 键 词：老年人 全身麻醉 连续硬膜外麻醉 麻黄素和(或)多巴胺使用率 心率 血压 

分 类 号：R61[医药卫生—外科学]