椎管内麻醉对股骨转子间骨折患者血液流变学指标及术后恢复的影响  

Effect of Intraspinal Anesthesia on Hemorheological Indexes and Postoperative Recovery in Patients with Intertrochanteric Fracture of Femur

作　　者：李高坤 陈金领 徐超 LI Gaokun;CHEN Jinling;XU Chao(Department of Anesthesiology,Xianyou General Hospital,Putian 351200,China;Department of Anesthesiology,Xianyou Maternal and Child Health Hospital,Putian 351200,China)

机构地区：[1]仙游县总医院麻醉科,莆田351200 [2]仙游县妇幼保健院麻醉科,莆田351200

出　　处：《中国医药指南》2024年第35期56-58,共3页Guide of China Medicine

摘　　要：目的研究椎管内麻醉对股骨转子间骨折患者的血液流变学参数以及手术后的恢复情况的影响。方法选取2021年1月至2023年12月仙游县总医院收治的126例股骨转子间骨折患者,通过随机数字表法均分为观察组(63例)和对照组(63例)。对照组患者接受全身麻醉,观察组患者采用10%的葡萄糖溶液和12 mg的罗哌卡因进行椎管内麻醉。比较两组围手术期指标(手术时间、术中出血量、术后下地活动时间和住院时间)、舒张压、收缩压、心率、血液流变学指标(血浆黏度、全血还原黏度、血小板聚集率和纤维蛋白原)和并发症发生情况。结果相较于对照组,观察组手术时间、术中出血量、术后下地活动时间以及住院时间更少(P<0.05)。与术前比较,两组术后舒张压、收缩压、心率上升,且观察组低于对照组(P<0.05)。术后,两组血浆黏度、全血还原黏度、血小板聚集率和纤维蛋白原水平均低于术前,且观察组低于对照组(P<0.05)。对照组并发症总发生率为14.29%,高于观察组的3.18%(P<0.05)。结论与全身麻醉相比,椎管内麻醉对于股骨转子间骨折患者不仅有助于手术后的快速恢复,对血流动力学的影响较小,有效维持血液流变学的稳定性,具有较高的安全性。Objective To investigate the effects of intrathecal anesthesia on the hemorheological parameters and postoperative recovery in patients with intertrochanteric femoral fractures.Methods A total of 126 patients with intertrochanteric femoral fractures admitted to Xianyou General Hospital from January 2021 to December 2023 were included.They were randomly divided into two groups using a random number table:observation group group(63 cases)and control group(63 cases).Patients in control group received general anesthesia,while those inobservation group group were administered intrathecal anesthesia with 10%glucose solution and 12 mg of ropivacaine.We compared the perioperative indices(operation time,intraoperative blood loss,time to ambulation after surgery,and hospital stay),diastolic pressure,systolic pressure,heart rate,hemorheological parameters(plasma viscosity,whole blood reduced viscosity,platelet aggregation rate,and fibrinogen),and the incidence of complications between the two groups.Results Compared to control group,observation group group had shorter operation times,less intraoperative blood loss,earlier time to ambulation,and shorter hospital stays(P<0.05).Compared to preoperative levels,both groups had increased diastolic pressure,systolic pressure,and heart rate postoperatively,withobservation group group showing lower values than control group(P<0.05).Postoperatively,the levels of plasma viscosity,whole blood reduced viscosity,platelet aggregation rate,and fibrinogen were lower in both groups compared to preoperative levels,withobservation group group showing lower values than control group(P<0.05).The total incidence of complications in control group was 14.29%,which was higher than the 3.18%inobservation group group(P<0.05).Conclusions Intrathecal anesthesia,compared to general anesthesia,not only facilitates rapid recovery after surgery in patients with intertrochanteric femoral fractures but also has a smaller impact on hemodynamics,effectively maintains the stability of hemorheology,and has a high

关 键 词：股骨转子间骨折 椎管内麻醉 血液流变学 术后恢复 

分 类 号：R614[医药卫生—麻醉学]