老年髋关节置换术患者麻醉方案应用的研究进展  

Research Progress on the Application of Anesthesia Protocol in Elderly Patients Undergoing Hip Replacement

作　　者：李屹[1] 任万陆 LI Yi;REN Wanlu(Department of Anesthesiology,Tianjin Hospital,Tianjin 300000,China)

机构地区：[1]天津市天津医院麻醉科,天津300000

出　　处：《中国伤残医学》2024年第22期155-160,共6页Chinese Journal of Trauma and Disability Medicine

摘　　要：在老年患者髋关节置换术的具体操作过程中,麻醉管理是非常重要的术中管理项目,具有复杂性、持续性、细致性等特点,涉及髋关节置换术的术前评估、术中监控及术后管理三个阶段。现阶段,可用于老年患者髋关节置换术的麻醉方式较多,如全身麻醉、椎管内麻醉及区域阻滞等麻醉手段,此外,还可采取各种联合麻醉手段,每种麻醉手段都有着各自的突出优势和应用效果,但目前临床尚未确定哪种麻醉方式最为有效,需根据患者的实际情况灵活进行选择。从老年患者髋关节置换术的麻醉管理发展演变情况来看,髋关节置换术的麻醉方法发展经历了多个阶段,其中包括对全身麻醉和区域麻醉的比较和研究,以及加速康复外科(ERAS)理念对麻醉方式的影响。临床医学领域对老年患者髋关节置换术的全身麻醉和区域麻醉优劣势研究已持续多年,但仍没有十分确切的研究结论证明上述几种麻醉方式可在实际应用中展现出绝对优势。伴随ERAS理念的推广,老年患者髋关节置换术的麻醉应用研究会持续进行深度探究。基于此,本文简要分析老年患者髋关节置换术的麻醉研究进展,以期为临床提供参考。In the specific operation process of hip replacement in elderly patients,anesthesia management is a very important intraoperative management project,which is characterized by complexity,continuity and meticulousness,involving three stages of preoperative evaluation,intraoperative monitoring and postoperative management of hip replacement.At present,there are many anesthesia methods that can be used for hip replacement in elderly patients,such as general anesthesia,intra-spinal anesthesia,regional block and other anesthesia methods,in addition,a variety of combined anesthesia means can be adopted,each anesthesia means has its own outstanding advantages and application effects,but the clinical has not yet determined which anesthesia method is the most effective,need to be flexibly selected according to the actual situation of patients.From the perspective of the development and evolution of anesthesia management for hip replacement in elderly patients,the development of anesthesia methods for hip replacement has gone through multiple stages,including the comparison and study of general anesthesia and regional anesthesia,as well as the influence of the concept of enhanced recovery after surgery(ERAS)on anesthesia methods.The research on the advantages and disadvantages of general anesthesia and regional anesthesia in the field of clinical medicine for elderly patients with hip replacement has lasted for many years,but there is still no exact research conclusion to prove that the above anesthesia methods can show absolute advantages in practical application.With the promotion of ERAS concept,the research on the application of anesthesia in hip replacement in elderly patients will continue to be deeply explored.Based on this,this paper briefly analyzes the research progress of anesthesia in elderly patients with hip replacement,in order to provide clinical reference.

关 键 词：髋关节置换术 老年患者 麻醉管理 连续硬膜外麻醉 

分 类 号：R614[医药卫生—麻醉学]