腰硬联合麻醉对于高龄髋部骨科手术患者的效果分析  

Analysis of the Effect of Combined Spinal Epidural Anesthesia on Elderly Patients Undergoing Hip Orthopedic Surgery

作　　者：王仁军 孔德赟 许常娥 WANG Renjun;KONG Deyun;XU Chang'e(Department of Anesthesiology,Zhenjiang Hospital of Integrated Traditional Chinese and Western Medicine,Zhenji-ang,Jiangsu Province,212002 China;Department of Anesthesiology,the Fourth Affiliated Hospital of Nanjing Medi-cal University,Nanjing,Jiangsu Province,210031 China)

机构地区：[1]镇江市中西医结合医院麻醉科,江苏镇江212002 [2]南京医科大学第四附属医院麻醉科,江苏南京210031

出　　处：《系统医学》2023年第12期95-98,共4页Systems Medicine

摘　　要：目的探讨对高龄髋部骨科手术患者分别给予腰硬联合麻醉以及硬膜外麻醉后的临床效果。方法选取2020年3月—2022年7月镇江市中西医结合医院的66例高龄髋部骨科手术患者作为研究对象,以投掷硬币法作为麻醉研究分组依据,参照组(n=33),施以硬膜外麻醉,研究组(n=33)施以腰硬联合麻醉,对比两组患者舒张压水平、收缩压水平、心率、痛觉完全消失时间以及麻醉起效时间。结果麻醉后,研究组舒张压、收缩压以及心率明显高于参照组,差异有统计学意义(P<0.05);研究组痛觉完全消失时间为(6.35±1.02)min、麻醉起效时间为(2.85±0.25)min明显短于参照组,差异有统计学意义(t=8.168,8.140,P<0.05)。结论临床对高龄髋部骨科手术患者合理给予腰硬联合麻醉干预,同硬膜外麻醉比较,可减小对患者舒张压、收缩压、心率水平的影响,有效缩短痛觉完全消失时间以及麻醉起效时间,对高龄髋部骨科患者的顺利手术做出保证。Objective To investigate the clinical effects of lumbar epidural anesthesia and epidural anesthesia in el⁃derly patients undergoing hip orthopedic surgery.Methods 66 elderly patients with hip orthopedic surgery in Zhenji⁃ang Hospital of Integrated Traditional Chinese and Western Medicine from March 2020 to July 2022 were selected as the study objects.The anesthesia study group was based on the coin tossing method.The reference group received epi⁃dural anesthesia,while the study group received combined spinal anesthesia.The level of diastolic blood pressure,sys⁃tolic blood pressure,heart rate,the time for pain to disappear completely and the time for anesthesia to take effect were compared between the two groups.Results After anesthesia,the levels of diastolic blood pressure,systolic blood pressure and heart rate in the study group were significantly higher than those in the reference group,and the differ⁃ence was statistically significant(P<0.05).The time of complete pain disappearance in the study group was(6.35±1.02)min,and the time of anesthesia onset was(2.85±0.25)min,which was significantly shorter than that in the refer⁃ence group,and the difference was statistically significant(t=8.168,8.140,P<0.05).Conclusion Compared with epi⁃dural anesthesia,reasonable combination of lumbar and epidural anesthesia can reduce the influence on diastolic blood pressure,systolic blood pressure and heart rate of patients,effectively shorten the time of complete loss of pain and the time of anesthesia effect,and ensure the smooth operation of elderly patients with hip orthopaedic.

关 键 词：高龄髋部骨科手术 腰硬联合麻醉 硬膜外麻醉 应用效果 

分 类 号：R614[医药卫生—麻醉学]