腰硬联合麻醉对患有高血压的老年髋关节置换术患者血管弹性及应激反应的影响  

Effects of combined lumbar and epidural anesthesia on vascular elasticity and stress response in elderly patients with hypertension undergoing hip replacement

作　　者：夏茜 XIA Qian(Mianyang Central Hospital,Mianyang 621099,Sichuan,China)

机构地区：[1]绵阳市中心医院,四川绵阳621099

出　　处：《当代医药论丛》2022年第13期87-89,共3页

摘　　要：目的:分析腰硬联合麻醉对患有高血压的老年髋关节置换术患者血管弹性及应激反应的影响。方法:对2020年6月至12月在绵阳市中心医院接受髋关节置换术的60例老年髋部骨折患者(患有高血压)的临床资料进行回顾性分析。将其随机分为参照组和研究组。对参照组30例患者实施全身麻醉,对研究组30例患者实施腰硬联合麻醉。然后比较两组患者的应激反应指标及血管弹性指标。结果:(1)麻醉前,两组患者皮质醇(Cor)、肾上腺素(E)及去甲肾上腺素(NE)的水平相比,差异无统计学意义(P>0.05)。麻醉后5 min及手术结束时,研究组患者Cor、NE、E的水平均低于参照组患者,差异有统计学意义(P<0.05)。(2)在术前,两组患者下肢动脉的僵硬度系数(β)、压力应变弹性系数(Ep)及顺应性(AC)相比,差异无统计学意义(P>0.05)。在术后,研究组患者下肢动脉的β、Ep均低于参照组患者,其下肢动脉的AC均高于参照组患者,差异有统计学意义(P<0.05)。结论:对患有高血压的老年髋关节置换术患者实施腰硬联合麻醉可取得较好的效果,能减轻其手术应激反应,且对其血管弹性的影响较小。Objective:To analyze the effects of combined lumbar and epidural anesthesia on vascular elasticity and stress response in elderly patients with hypertension undergoing hip replacement.Methods:The clinical data of 60 elderly patients with hip fracture(hypertension)who underwent hip replacement in Mianyang Central Hospital from June to December 2020 were retrospectively analyzed.They were randomly divided into a control group and a study group.30 patients in the reference group were given general anesthesia,and 30 patients in the research group were given combined lumbar and epidural anesthesia.Then the stress response indexes and vascular elasticity indexes of the two groups were compared.Results:(1)Before anesthesia,there were no significant differences in the levels of cortisol(Cor),adrenaline(E)and norepinephrine(NE)between 2 groups(P>0.05).The levels of Cor,NE and E in the study group were lower than those in the reference group at 5 min after anesthesia and at the end of surgery,with statistical significance(P<0.05).(2)Before surgery,there were no statistically significant differences in stiffness coefficient(β),elasticity coefficient of pressure strain(Ep)and compliance(AC)of lower limb arteries between 2 groups(P>0.05).After surgery,the lower limb arteryβand Ep in the study group were lower than those in the reference group,and the lower limb artery AC was higher than that in the reference group,the differences were statistically significant(P<0.05).Conclusion:Combined lumbar and epidural anesthesia can achieve better results in elderly hypertensive patients with hip arthroplasty,which can reduce the surgical stress response,an d has little effect on vascular elasticity.

关 键 词：老年 高血压 髋关节置换术 腰硬联合麻醉 全身麻醉 血管弹性 应激反应 

分 类 号：R614[医药卫生—麻醉学]