术前不同麻醉方式对老年髋部骨折患者睡眠质量及术后谵妄发生率的影响  

Effects of different preoperative anesthesia methods on sleep quality and incidence of postoperative delirium in elderly patients with hip fracture

作　　者：张永[1] ZHANG Yong(Huaxian People's Hospital of Henan,Anyang 456400,China)

机构地区：[1]河南省滑县人民医院,河南安阳456400

出　　处：《临床医学研究与实践》2025年第2期73-76,共4页Clinical Research and Practice

摘　　要：目的分析术前不同麻醉方式对老年髋部骨折患者睡眠质量及术后谵妄发生率的影响。方法选取2021年3月至2023年3月我院收治的120例行手术治疗的老年髋部骨折患者为研究对象,以麻醉方式差异将其分为常规组(60例,全身麻醉)和观察组(60例,腰硬联合麻醉)。比较两组的生命体征指标、血流动力学指标、术中呼吸循环抑制情况及术后不良反应发生情况。结果入室时(T_(0)),两组的心率(HR)、血氧饱和度(SpO_(2))、平均动脉压(MAP)、中心静脉压(CVP)、平均肺动脉压(MPAP)比较,差异无统计学意义(P>0.05);插管时(T_(1))~拔管时(T_(4)),观察组的HR、SpO_(2)、MAP、CVP、MPAP高于常规组,差异具有统计学意义(P<0.05);观察组手术过程中生命体征及血流动力学指标的波动幅度小于常规组。观察组的术中呼吸循环抑制(心动过缓、低血压、呼吸抑制)及术后不良反应(谵妄、恶心呕吐、认知障碍、睡眠障碍)总发生率低于常规组,差异具有统计学意义(P<0.05)。结论术前腰硬联合麻醉对老年髋部骨折患者具有更佳安全性及预后保障,值得临床推广和应用。Objective To analyze the effects of different preoperative anesthesia methods on sleep quality and incidence of postoperative delirium in elderly patients with hip fracture.Methods A total of 120 elderly patients with hip fracture who underwent surgical treatment in our hospital from March 2021 to March 2023 were selected as the research objects.The patients were divided into conventional group(60 cases,general anesthesia)and observation group(60 cases,combined spinal-epidural anesthesia)according to the difference of anesthesia methods.The vital signs indexes,hemodynamic indexes,occurrence of intraoperative respiratory and circulatory inhibition and postoperative adverse reactions were compared between the two groups.Results When entering the room(T_(0)),there were no significant differences in heart rate(HR),blood oxygen saturation(SpO_(2)),mean arterial pressure(MAP),central venous pressure(CVP)and mean pulmonary artery pressure(MPAP)between the two groups(P>0.05);from intubation(T_(1))to extubation(T_(4)),HR,SpO_(2),MAP,CVP and MPAP in the observation group were higher than those in the conventional group,and the differences were statistically significant(P<0.05);the fluctuation range of vital signs and hemodynamic indexes during operation in the observation group were smaller than those in the conventional group.The total incidence of intraoperative respiratory and circulatory inhibition(bradycardia,hypotension,respiratory inhibitory)and postoperative adverse reactions(delirium,nausea and vomiting,cognitive impairment,sleep disorder)in the observation group were lower than those in the conventional group,and the differences were statistically significant(P<0.05).Conclusion Preoperative combined spinal-epidural anesthesia has better safety and prognosis for elderly patients with hip fracture,which is worthy of clinical promotion and application.

关 键 词：老年 髋部骨折 手术麻醉 全身麻醉 腰硬联合麻醉 

分 类 号：R614[医药卫生—麻醉学]