老年下肢骨折患者采用腰硬联合麻醉与全身麻醉的麻醉效果分析  

Analysis of anesthesia effect of combined spinal-epidural anesthesia and general anesthesia in elderly patients with lower extremity fracture

作　　者：张传利 ZHANG Chuan-li(Department of Anesthesiology,Heze Hospital of Traditional Chinese Medicine,Heze 274000,China)

机构地区：[1]菏泽市中医医院麻醉科,274000

出　　处：《中国实用医药》2024年第6期123-126,共4页China Practical Medicine

摘　　要：目的 探究老年下肢骨折患者采用腰硬联合麻醉与全身麻醉的麻醉效果。方法 90例老年下肢骨折患者为研究对象,依据随机数字表法分为观察组与对照组,各45例。对照组应用全身麻醉,观察组应用腰硬联合麻醉。比较两组视觉模拟评分法(VAS)评分、简易智力状态检查量表(MMSE)评分、凝血指标[凝血酶时间(TT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)]、手术相关指标。结果 术后6、12、24 h,观察组VAS评分分别为(3.75±1.51)、(2.17±0.17)、(0.64±0.35)分,低于对照组(4.55±1.74)、(3.99±0.25)、(2.18±0.55)分,数据对比有统计学意义(P<0.05)。两组术前、术后72 h的MMSE评分对比无统计学意义(P>0.05);术后6、12、24 h,观察组MMSE评分分别为(26.45±1.56)、(27.07±1.48)、(28.39±1.41)分,高于对照组的(20.02±1.31)、(26.15±1.22)、(27.26±1.38)分,数据对比有统计学意义(P<0.05)。术后1 h,观察组TT、PT、APTT分别为(17.69±1.14)、(11.70±1.33)、(37.03±2.42)s,均长于对照组的(16.46±1.57)、(10.36±1.16)、(35.60±2.25)s,数据对比有统计学意义(P<0.05)。两组麻醉总时间、手术总时间、术中出血量对比无统计学意义(P>0.05)。结论 在对老年下肢患者麻醉时,全身麻醉与腰硬联合麻醉的麻醉效果相当,腰硬联合麻醉可更好地缓解疼痛,维持凝血功能稳定,加快认知功能恢复,可推广。Objective To explore the anesthesia effect of combined spinal-epidural anesthesia and general anesthesia in elderly patients with lower extremity fracture.Methods 90 elderly patients with lower extremity fracture were studied and divided into an observation group and a control group according to random number table method,with 45 cases in each group.The control group was given general anesthesia,and the observation group was given combined spinal-epidural anesthesia.Comparison was made on visual analogue scale(VAS)score,mini-mental state examination(MMSE)score,coagulation index[thrombin time(TT),prothrombin time(PT),activated partial thromboplastin time(APTT)]and surgery-related indicators between the two groups.Results At 6,12 and 24 h postoperatively,VAS scores of the observation group were(3.75±1.51),(2.17±0.17)and(0.64±0.35)points,which were lower than(4.55±1.74),(3.99±0.25)and(2.18±0.55)points of the control group.The data were statistically significant(P<0.05).There was no statistical significance in MMSE scores between the two groups preoperatively and at 72 h postoperatively(P>0.05).MMSE scores of the observation group were(26.45±1.56),(27.07±1.48)and(28.39±1.41)points at 6,12 and 24 h postoperatively,which were higher than(20.02±1.31),(26.15±1.22)and(27.26±1.38)points of the control group.The data were statistically significant(P<0.05).At 1 h postoperatively,TT,PT and APTT in the observation group were(17.69±1.14),(11.70±1.33)and(37.03±2.42)s,which were longer than(16.46±1.57),(10.36±1.16)and(35.60±2.25)s in the control group.The data were statistically significant(P<0.05).There was no significant difference in total anesthesia time,total operation time and intraoperative blood loss between the two groups(P>0.05).Conclusion In the anesthesia of elderly patients with lower extremity fracture,the anesthetic effect of general anesthesia is comparable to that of combined spinal-epidural anesthesia.Combined spinal-epidural anesthesia can better relieve pain,maintain coagulation function,acce

关 键 词：下肢骨折 腰硬联合麻醉 全身麻醉 麻醉效果 老年 

分 类 号：R614[医药卫生—麻醉学]