本文選題：關(guān)節(jié)成形術(shù) + 置換��； 參考：《中國(guó)組織工程研究》2015年13期

【摘要】：背景:腰-硬聯(lián)合麻醉和硬膜外麻醉均是老年人手術(shù)中常用的麻醉方式,各有優(yōu)缺點(diǎn)。采用合適的麻醉方式保持循環(huán)穩(wěn)定可以降低患者的手術(shù)風(fēng)險(xiǎn)和并發(fā)癥,提高治療成功率。目的:分析對(duì)比硬膜外麻醉與腰-硬聯(lián)合麻醉在老年髖關(guān)節(jié)置換中的麻醉效果以及對(duì)于血流動(dòng)力學(xué)的影響。方法:選擇髖關(guān)節(jié)置換老年患者80例,隨機(jī)分為兩組,每組40例,試驗(yàn)組予以腰-硬聯(lián)合麻醉,對(duì)照組予以硬膜外麻醉。對(duì)比兩組患者各時(shí)間點(diǎn)的平均動(dòng)脈壓、心率和中心靜脈壓變化,感覺(jué)、運(yùn)動(dòng)阻滯起效及恢復(fù)時(shí)間,麻醉后30 min各阻滯平面和Bromage運(yùn)動(dòng)阻滯評(píng)分以及麻醉效果。結(jié)果與結(jié)論:對(duì)照組麻醉后5 min、30 min和術(shù)畢的平均動(dòng)脈壓顯著低于麻醉前和試驗(yàn)組同時(shí)間點(diǎn)(P0.05);對(duì)照組麻醉后5 min、30 min和術(shù)畢的心率顯著高于麻醉前和試驗(yàn)組同時(shí)間點(diǎn)(P0.05);對(duì)照組麻醉后5 min、30 min和術(shù)畢的中心靜脈壓顯著高于麻醉前和試驗(yàn)組同時(shí)間點(diǎn)(P0.05)。試驗(yàn)組的感覺(jué)、運(yùn)動(dòng)阻滯起效時(shí)間顯著短于對(duì)照組,感覺(jué)、運(yùn)動(dòng)阻滯恢復(fù)時(shí)間顯著長(zhǎng)于對(duì)照組(P0.01)。兩組患者麻醉后30 min各阻滯平面和Bromage運(yùn)動(dòng)阻滯評(píng)分差異無(wú)顯著性意義(P0.05)。試驗(yàn)組的麻醉效果顯著優(yōu)于對(duì)照組(χ2=5.691 7,P=0.017 00.05)。提示與硬膜外麻醉相比,腰-硬聯(lián)合麻醉可以減少髖關(guān)節(jié)置換患者的血流動(dòng)力學(xué)變化,麻醉效果更佳。
[Abstract]:Background: combined spinal-epidural anesthesia and epidural anesthesia are common anesthetic methods in the elderly, each has its own advantages and disadvantages. Proper anesthesia to maintain stable circulation can reduce the surgical risk and complications, and improve the success rate of treatment. Aim: to compare the effects of epidural anesthesia and combined spinal-epidural anesthesia on hip replacement and hemodynamics in elderly patients. Methods: 80 elderly hip replacement patients were randomly divided into two groups, 40 cases in each group. The experimental group was given combined spinal-epidural anesthesia and the control group was given epidural anesthesia. The changes of mean arterial pressure, heart rate and central venous pressure, sensation, time of onset and recovery of motor block, scores of block level and Bromage block at 30 min after anesthesia and anaesthesia effect were compared between the two groups. Results and conclusion: the mean arterial pressure at 30 min after anesthesia and at the end of operation in the control group was significantly lower than that in the control group at the same time point before anesthesia and at the same time point (P0.05), and the heart rate in the control group was significantly higher than that in the control group at 5 minutes after anesthesia and the heart rate at the end of operation at the same time point before anesthesia and in the test group. The central venous pressure at 30 min after anesthesia in the control group was significantly higher than that in the control group and at the same time point before anesthesia and at the same time point in the experimental group. In the experimental group, the onset time of motor block was significantly shorter than that of the control group, and the recovery time of motor block was significantly longer than that of the control group (P 0.01). There was no significant difference in block level and Bromage motor block score 30 min after anesthesia between the two groups (P 0.05). The anaesthesia effect of the trial group was significantly better than that of the control group (蠂 ~ 2 = 5.6917). Compared with epidural anesthesia, combined spinal-epidural anesthesia can reduce hemodynamic changes in hip replacement patients, and the anesthetic effect is better.
【作者單位】： 中山市黃圃人民醫(yī)院麻醉科;
【分類(lèi)號(hào)】：R614

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本文編號(hào)：2019050