本文選題：硬膜外麻醉　切入點(diǎn)：靜脈麻醉　出處：《中國骨與關(guān)節(jié)損傷雜志》2016年08期 　論文類型：期刊論文

【摘要】：目的探討硬膜外麻醉復(fù)合小劑量靜脈麻醉對類風(fēng)濕關(guān)節(jié)炎伴關(guān)節(jié)畸形行全膝關(guān)節(jié)置換術(shù)(TKA)患者術(shù)后下肢深靜脈血栓(DVT)形成的影響。方法自2010-01—2015-08共診治因類風(fēng)濕性關(guān)節(jié)炎伴關(guān)節(jié)畸形而行TKA的患者60例,按隨機(jī)數(shù)字法平均分為3組,術(shù)中分別采用連續(xù)硬膜外麻醉(A組)、靜-吸復(fù)合全身麻醉(B組)和硬膜外麻醉復(fù)合小劑量靜脈麻醉(C組),觀察3組DVT的發(fā)生率、術(shù)中血流動力學(xué)和應(yīng)激功能指標(biāo)。結(jié)果 B組血漿纖維蛋白原和D-二聚體水平高于其他2組,而抗X因子活性峰值低于其他2組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。T0時間點(diǎn)3組血壓,心率和BIS值水平均無明顯差異,而T1和T2時間點(diǎn)B組血壓、心率、BIS值均顯著低于其他2組(P0.05);B組DVT發(fā)生率高于其他2組,差異有統(tǒng)計(jì)學(xué)意義(χ~2=13.2,P=0.01)。結(jié)論硬膜外麻醉復(fù)合小劑量靜脈麻醉可穩(wěn)定術(shù)中血流動力學(xué),麻醉效果佳,降低下肢深靜脈血栓發(fā)生率,其機(jī)制與抑制凝血過程有關(guān)。
[Abstract]:Objective to investigate the effect of epidural anesthesia combined with low dose intravenous anesthesia on the formation of DVT in patients with rheumatoid arthritis with joint deformity after total knee arthroplasty. Methods the diagnosis and treatment of rheumatoid rheumatoid syndrome were performed from 2010-01-2015-08. TKA was performed in 60 patients with ganglitis associated with joint deformities. According to the random number method, the patients were divided into three groups: group A (continuous epidural anesthesia), group B (combined with general anesthesia) and group C (combined with epidural anesthesia and small dose intravenous anesthesia). The incidence of DVT in the three groups was observed. Results the plasma fibrinogen and D-dimer levels in group B were higher than those in the other two groups, but the peak value of anti-X factor activity was lower than that in the other two groups. There was no significant difference in heart rate and BIS, but the incidence of DVT in group B was significantly lower than that in group B at T 1 and T 2, which was significantly lower than that in group B (P 0.05) and the incidence of DVT in group B was higher than that in group B at T 1 and T 2, respectively. Conclusion epidural anesthesia combined with small dose intravenous anesthesia can stabilize hemodynamics during operation and reduce the incidence of deep venous thrombosis in lower extremity. The mechanism is related to the inhibition of coagulation.
【作者單位】： 當(dāng)陽長坂坡醫(yī)院麻醉科;
【分類號】：R614

【相似文獻(xiàn)】

中國期刊全文數(shù)據(jù)庫 前10條

1 王聚民,孟慶友,宋顯明,陳淑敏;腹腔鏡膽囊切除術(shù)硬膜外麻醉體會[J];前衛(wèi)醫(yī)藥雜志;2000年04期

2 陳序;硬膜外麻醉在高齡前列腺汽化電切術(shù)的應(yīng)用(56例分析)[J];廣西醫(yī)學(xué);2001年02期

3 牟翠萍;老年患者硬膜外麻醉下經(jīng)尿道前列腺切除術(shù)513例報(bào)告[J];現(xiàn)代醫(yī)藥衛(wèi)生;2001年12期

4 孫建;硬膜外麻醉致異常廣泛阻滯的分析[J];黑龍江醫(yī)學(xué);2002年08期

5 洪自賢;硬膜外麻醉在腹腔鏡膽囊切除術(shù)中的應(yīng)用[J];川北醫(yī)學(xué)院學(xué)報(bào);2002年02期

6 楊瑞,田蘇萬,楊春艷,石慧文;75歲以上老年人的硬膜外麻醉的體會[J];醫(yī)學(xué)理論與實(shí)踐;2002年07期

7 張瑞云,狄文榮;硬膜外麻醉致廣泛性阻滯2例[J];現(xiàn)代中西醫(yī)結(jié)合雜志;2004年18期

8 魏世珍,張娟;1500例單次硬膜外麻醉效果分析[J];華中醫(yī)學(xué)雜志;2004年05期

9 陳淑明;淺談老年人硬膜外麻醉中的若干問題及其處理對策[J];中醫(yī)藥導(dǎo)報(bào);2005年05期

10 張鳳云,楊開蘭;硬膜外麻醉輔以咪唑安定鎮(zhèn)靜引起極度躁動的分析[J];現(xiàn)代醫(yī)藥衛(wèi)生;2005年03期

中國重要會議論文全文數(shù)據(jù)庫 前10條

1 肖翠容;蔣宗濱;黃子津;冼海燕;馮梅;;帕瑞昔布鈉用于硬膜外麻醉手術(shù)輔助鎮(zhèn)痛的臨床研究[A];第十五次長江流域麻醉學(xué)學(xué)術(shù)年會暨2010年中南六省麻醉學(xué)學(xué)術(shù)年會暨2010年湖北省麻醉學(xué)學(xué)術(shù)年會論文集[C];2010年

2 裴麗霞;;硬膜外麻醉應(yīng)用標(biāo)本的制作[A];第三屆全國解剖學(xué)技術(shù)會議論文集[C];2011年

3 岳云;;硬膜外麻醉的臨床價值及并發(fā)癥的防治[A];中華醫(yī)學(xué)會第二十次全國麻醉學(xué)術(shù)年會論文匯編[C];2012年

4 殷世平;黃玉芹;呂亞t，

本文編號：1569222