B超引导下神经阻滞麻醉联合全麻对老年下肢骨科手术患者麻醉效果的影响  

Influence of B-ultrasound Guided Nerve Block Anesthesia Combined with General Anesthesia on the Effect of Anesthesia in Elderly Patients Undergoing Orthopedic Surgery on Lower Limbs

作　　者：李仁超 刘继东 LI Renchao;LIU Jidong(Department of Anesthesiology,Shanxian Central Hospital,Heze,Shandong Province,274300 China)

机构地区：[1]山东省菏泽市单县中心医院麻醉科,山东菏泽274300

出　　处：《中外医疗》2021年第20期53-56,共4页China & Foreign Medical Treatment

摘　　要：目的分析B超引导下神经阻滞麻醉+全身麻醉对老年下肢骨科手术患者的效果。方法以随机数表法,于2019年1月—2020年8月在该院行下肢骨科手术患者中随机抽取110例,依据患者先后入院时间分为对照组(55例)、观察组(55例),对照组采用全身麻醉,观察组采用B超引导下神经阻滞麻醉+全身麻醉,对比两组麻醉情况,凝血功能,血流动力学指标。结果两组患者对比,观察组的麻醉起效时间、苏醒时间、拔管时间(4.46±1.45)min、(9.55±3.51)s、(10.54±4.57)min更优,差异有统计学意义(t=16.699、5.626、6.162,P<0.05)。入室后,两组凝血功能指标对比差异无统计学意义(t=0.131、1.916、0.176,P>0.05);在术中1 h、拔除喉罩时,观察组的凝血酶原时间(PT)为(11.39±0.78)s与(12.68±0.89)s,凝血酶时间(TT)为(14.85±0.91)s与(15.69±0.88)s,活化部分凝血活酶时间(APTT)为(22.67±1.82)s、(24.89±1.64)s,明显优于对照组,差异有统计学意义(t=3.471、9.749、5.164、8.750、2.324、7.669,P<0.05)。诱导前,两组血流动力学指标差异无统计学意义(t=0.348、0.202、0.063,P>0.05);术中1 h、拔除喉罩时,观察组的平均动脉压(MAP)为(96.61±12.18)mmHg、(99.68±13.56)mmHg,心率(HR)为(69.25±9.58)次/min、(72.45±8.90)次/min,中心静脉压(CVP)为(8.42±1.80)cmH2O、(8.42±1.61)cmH2O,明显优于对照组,差异有统计学意义(t=4.485、3.861、5.873、6.285、2.029、2.154,P<0.05)。结论对于老年下肢骨科患者,进行手术时采取B超引导下神经阻滞麻醉+全身麻醉效果显著。Objective To analyze the effect of nerve block anesthesia+general anesthesia guided by B-ultrasound on elderly patients with lower limb orthopedic surgery.Methods According to the random number table method,110 patients who underwent lower limb orthopedic surgery in the hospital from January 2019 to August 2020 were randomly selected and divided into the control group(55 cases)and the observation group(55 cases)according to the time of admission,control group adopted general anesthesia,observation group adopted B-ultrasound guided nerve block anesthesia+general anesthesia,compare the two groups of anesthesia,coagulation function,hemodynamic indicators.Results Comparing the patients of two groups,the observation group's anesthesia onset time,wake-up time,extubation time(4.46±1.45)min,(9.55±3.51)s,(10.54±4.57)min were better,the difference was statistically significant(t=16.699,5.626,6.162,P<0.05).After entering the room,there was no statistically significant difference in the coagulation function index between the two groups(t=0.131,1.916,0.176,P>0.05);at 1 h during the operation and when the laryngeal mask was removed,the prothrombin time(PT)of the observation group was(11.39±0.78)s and(12.68±0.89)s,thrombin time(TT)was(14.85±0.91)s and(15.69±0.88)s,activated partial thromboplastin time(APTT)was(22.67±1.82)s,(24.89±1.64)s,which was significantly better than the control group,the difference was statistically significant(t=3.471,9.749,5.164,8.750,2.324,7.669,P<0.05).Before induction,there was no statistically significant difference in hemodynamic indexes between the two groups(t=0.348,0.202,0.063,P>0.05);1 h intraoperatively and when the laryngeal mask was removed,the mean arterial pressure(MAP)of the observation group was(96.61±12.18)mmHg,(99.68±13.56)mmHg,heart rate(HR)was(69.25±9.58)times/min,(72.45±8.90)times/min,central venous pressure(CVP)was(8.42±1.80)cmH2O,(8.42±1.61)cmH2O,significantly better than the control group,the difference was statistically significant(t=4.485,3.861,5.873,6.285,2.029,

关 键 词：B超 血流动力学 凝血功能 麻醉 

分 类 号：R614.2[医药卫生—麻醉学]