椎管内与全身麻醉方案对高龄骨科患者围术期血流动力学及术后静脉血栓发生率的影响  

Effects of intraspinal and general anesthesia on perioperative hemodynamics and incidence of postoperative deep venous thrombosis in elderly orthopedic patients

作　　者：付荣 许龙 何道辉 Fu Rong;Xu Long;He Dao-hui(Department of Anesthesiology,Nancheng People's Hospital,Fuzhou 344700,Jiangxi,China)

机构地区：[1]南城县人民医院麻醉科,江西抚州344700

出　　处：《四川生理科学杂志》2025年第4期903-905,共3页

摘　　要：目的:探讨椎管内与全身麻醉方案对高龄骨科患者围术期血流动力学及术后静脉血栓(DVT)发生率的影响。方法:选取2022年6月到2024年10月本院看诊的108例高龄骨科患者进行研究,将所有患者随机分为两组:分为观察组(n=54)、对照组(n=54)。以上两组患者分别实施椎管内麻醉、全身麻醉。对两组麻醉效果指标进行观察;对比两组麻醉前(T1)、手术开始即刻(T2)、手术结束即刻(T3)、(T4)的平均动脉压(MAP)、心率(HR);对患者术后3m进行电话随访,记录2组静脉血栓(DVT)发生情况。结果:与对照组相比,观察组手术时间和术后下床活动时间更短,麻醉用药量更少(P<0.05);与对照组相比较,观察组麻醉效果指标更优(P<0.05);与T1时相比,T2~T4观察组HR、MAP数值低于对照组(P<0.05);HR、MAP组间、时间点及交互差异均有统计学意义(P<0.05),观察组各时间点HR、MAP均低于对照组(P<0.05);术后3m电话随访发现,与对照组相比,观察组DVT发生率更低(P<0.05)。结论:针对高龄骨科患者实施椎管内麻醉较全身麻醉方案优势更为明显,对围术期血流动力学影响较小,可缩短手术时间及下床活动时间,有效减少DVT的发生。Objective:To explore the effects of intraspinal and general anesthesia on perioperative hemodynamics and incidence of postoperative deep venous thrombosis(DVT)in elderly orthopedic patients.Methods:A total of 108 elderly orthopedic patients treated in the hospital were enrolled between June 2022 and October 2024,and they were randomly divided into observation group(n=54,intraspinal anesthesia)and control group(n=54,general anesthesia).The anesthetic effect indexes in the two groups were observed.The mean arterial pressure(MAP)and heart rate(HR)in the two groups were compared before induced anesthesia(T1),immediately after intubation(T2),skin incision(T3),six hours after surgery(T4).The patients were given telephone follow-up at 3 months after surgery to record occurrence of DVT.Results:Compared with control group,anesthetic effect indexes were better in observation group(P<0.05).Compared with T1,HR and MAP in observation group were lower than those in control group from T2-T5(P<0.05).There were significant differences in HR and MAP in terms of inter-group,time point and interaction dimensions(P<0.05),and which in observation group were lower than those in control group at each time point(P<0.05).According to telephone follow-up at 3 months after surgery,incidence of DVT in observation group was lower than that in control group(P<0.05).Conclusion:Compared with general anesthesia,intraspinal anesthesia has more obvious advantages in elderly orthopedic patients,which has fewer effects on perioperative hemodynamics,faster loss of consciousness and shorter recovery time,and can effectively reduce DVT.

关 键 词：椎管内麻醉 全身麻醉 高龄 骨科 血流动力学 术后静脉血栓 

分 类 号：R614[医药卫生—麻醉学]