腰-硬联合麻醉用于糖尿病下肢血管病变手术的麻醉效果分析  

Analysis of Anesthesia Effect of Combined Spinal-Epidural Anesthesia for Diabetic Lower Extremity Vascular Disease Surgery

作　　者：邹建方 ZOU Jianfang(Department of Anesthesiology,Weihai Wei People´s Hospital,Weihai,Shandong Province,264200 China)

机构地区：[1]威海卫人民医院麻醉科,山东威海264200

出　　处：《糖尿病新世界》2022年第18期187-190,共4页Diabetes New World Magazine

摘　　要：目的 讨论腰-硬联合麻醉用于糖尿病下肢血管病变手术的麻醉效果。方法 入选2020年10月—2022年2月于威海卫人民医院接受诊疗的60例糖尿病下肢血管病变患者,随机分为对照组30例与研究组30例。对照组采取全身麻醉,研究组采取腰-硬联合麻醉。对比两组麻醉效果、麻醉不良反应、麻醉时间指标、麻醉对术后恢复疼痛及认知影响、应激性高血糖发生率。结果 研究组麻醉优良率为96.67%,与对照组的93.33%比较,差异无统计学意义(P>0.05)。研究组麻醉不良反应发生率为3.33%,明显低于对照组的26.67%,差异有统计学意义(P<0.05)。研究组麻醉起效时间、麻醉最高阻滞平面、苏醒时间、定向力恢复时间均明显优于对照组,差异有统计学意义(P<0.05)。术后6、12 h及24 h后研究组认知功能升高程度明显高于对照组,疼痛度升高程度明显低于对照组,差异有统计学意义(P<0.05)。研究组应激性高血糖发生率为3.33%,明显低于对照组的23.33%,差异有统计学意义(P<0.05)。结论 腰-硬联合麻醉用于糖尿病下肢血管病变手术中将达到与全身麻醉优良性近乎一致,但是前者麻醉见效快,且对术后疼痛及认知功能恢复影响性较小,可降低应激性高血糖发生几率,麻醉安全性高。Objective To discuss the anesthesia effect of combined spinal-epidural anesthesia for diabetic lower extremity vascular disease surgery.Methods A total of 60 patients with diabetic lower extremity vascular disease were selected and received diagnosis and treatment from October 2020 to February 2022 in Weihai Wei People’s Hospital.They were randomly divided into a control group of 30 cases and a study group of 30 cases.The control group was given general anesthesia,and the study group was given combined spinal-epidural anesthesia.The anesthesia effect,adverse reactions of anesthesia,anesthesia time index,the effect of anesthesia on postoperative recovery pain and cognition,and the incidence of stress hyperglycemia were compared between the two groups.Results The excellent and good rate of anesthesia in the study group was 96.67%,compared with 93.33% in the control group,there was no statistically significant difference(P>0.05).The incidence of adverse reactions of anesthesia in the study group was3.33%,which was significantly lower than that in the control group(26.67%),and the difference was statistically significant(P<0.05).The onset time of anesthesia,the highest block level of anesthesia,the recovery time,and the recovery time of orientation force in the study group were significantly shorter than those in the control group,and the differences were statistically significant(P<0.05).After 6,12 and 24 hours after operation,the cognitive function in the study group was significantly increased,and the pain degree in the study group was significantly lower than that in the control group,the differences were statistically significant(P<0.05).The incidence rate of stress hyperglycemia in the study group was 3.33%,which was significantly lower than that in the control group(23.33%),and the difference was statistically significant(P<0.05).Conclusion Combined lumbar-epidural anesthesia for diabetic lower extremity vascular disease surgery will achieve almost the same superiority as general anesthesia,but the former an

关 键 词：糖尿病下肢血管病变 手术 全身麻醉 腰-硬联合麻醉 

分 类 号：R614[医药卫生—麻醉学]