连续硬膜外麻醉和蛛网膜下腔阻滞应用于高龄老年下肢骨折手术患者的有效性及安全性  

Efficacy and Safety of Continuous Epidural Anesthesia and Subarachnoid Block in Advanced Age Elderly Patients Undergoing Surgery for Lower Extremity Fracture

作　　者：赵红波 宋敏 秦玲丹 ZHAO Hongbo;SONG Min;QIN Lingdan(Zheng’an County People's Hospital,Zheng’an 563400,China;不详)

机构地区：[1]正安县人民医院,贵州正安563400

出　　处：《中外医学研究》2024年第35期63-67,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:观察连续硬膜外麻醉和蛛网膜下腔阻滞应用于高龄老年下肢骨折手术患者的有效性及安全性。方法:选取2022年1月—2023年12月正安县人民医院收治的80例高龄老年下肢骨折患者作为研究对象。随机将其分为对照组和观察组,各40例。对照组给予连续硬膜外麻醉,观察组给予蛛网膜下腔阻滞。比较两组入室时及麻醉10 min后生命体征,围手术期指标,术后3 h、6 h疼痛程度,不良反应及认知功能。结果:麻醉10 min后,观察组收缩压、舒张压及心率均优于对照组,差异有统计学意义(P<0.05)。观察组麻醉起效时间短于对照组,差异有统计学意义(P<0.05)。观察组术后3 h、6 h视觉模拟评分法(VAS)评分均低于对照组,差异有统计学意义(P<0.05)。观察组不良反应发生率低于对照组,差异有统计学意义(P<0.05)。观察组术后3 h、6 h简明精神状态量表(mini-mental state examination,MMSE)评分均高于对照组,差异有统计学意义(P<0.05)。结论:高龄老年下肢骨折手术患者应用蛛网膜下腔阻滞的麻醉起效时间更短,且对循环系统波动更小,安全有效,术后患者的疼痛评分更低。Objective:To observe the efficacy and safety of continuous epidural anesthesia and subarachnoid block in advanced age elderly patients undergoing surgery for lower extremity fracture.Method:Eighty advanced age elderly patients with lower extremity fracture treated in Zheng’an County People's Hospital from January 2022 to December 2023 were selected as the study objects.They were randomly divided into control group and observation group,40 cases in each group.The control group was given continuous epidural anesthesia,and the observation group was given subarachnoid block.The vital signs at entering the room and 10 minutes after anesthesia,perioperative indexes,pain degree 3 h and 6 h after surgery,adverse reactions and cognitive function were compared between the two groups.Result:After 10 min of anesthesia,the systolic blood pressure,diastolic blood pressure and heart rate of the observation group were better than those of the control group,the differences were statistically significant(P<0.05).The effective time of anesthesia in the observation group was shorter than that in the control group,the difference was statistically significant(P<0.05).Visual analogue scale(VAS)scores of the observation group were lower than those of the control group at 3 h and 6 h after surgery,and the differences were statistically significant(P<0.05).The incidence of adverse reactions in observation group was lower than that in control group,and the difference was statistically significant(P<0.05).The scores of mini-mental state examination(MMSE)in the observation group were higher than those in the control group at 3 h and 6 h after surgery,and the differences were statistically significant(P<0.05).Conclusion:The application of subarachnoid block anesthesia in elderly patients undergoing lower limb fracture surgery has a shorter onset time,smaller fluctuations in the circulatory system,is safe and effective,and lower postoperative pain scores.

关 键 词：连续硬膜外麻醉 蛛网膜下腔阻滞 高龄老年患者 下肢骨折手术 有效性 安全性 

分 类 号：R47[医药卫生—护理学]