【摘要】：目的觀察全身麻醉與硬膜外麻醉對全膝關(guān)節(jié)置換術(shù)高齡患者凝血功能與深靜脈血栓并發(fā)癥的影響。方法將80例行全膝關(guān)節(jié)置換術(shù)的高齡患者隨機(jī)分為2組,全麻組40例選擇全身麻醉,硬膜外組40例選擇硬膜外麻醉,記錄2組麻醉前(t1)、麻醉開始后30 min(t2)、手術(shù)結(jié)束時(t3)、術(shù)后1 d(t4)平均動脈壓(MAP)、心率(HR)、血氧飽和度[Sp(O_2)],檢測t1與t4時間點(diǎn)纖維蛋白原(FBG)水平、血小板計數(shù)(Plt)、活化部分凝血酶時間(APTT)及凝血酶原時間(PT)。結(jié)果 2組組內(nèi)和組間各時間點(diǎn)Sp(O_2)比較差異均無統(tǒng)計學(xué)意義(P均0.05);2組t2時間點(diǎn)MAP均明顯低于t1時間點(diǎn)(P均0.05),t3時間點(diǎn)MAP均明顯高于t2時間點(diǎn)(P均0.05),t4時間點(diǎn)MAP均明顯低于t3時間點(diǎn)(P均0.05),且全麻組t2~t4時間點(diǎn)MAP均明顯高于硬膜外組(P均0.05);2組t2、t3時間點(diǎn)HR明顯高于t1時間點(diǎn)(P均0.05),t4時間點(diǎn)HR均明顯低于t3時間點(diǎn)(P均0.05),但2組間比較差異均無統(tǒng)計學(xué)意義(P均0.05)。全麻組t4時間點(diǎn)FBG明顯高于t1時間點(diǎn)和硬膜外組(P均0.05),Plt、PT、APTT均明顯低于t1時間點(diǎn)和硬膜外組(P均0.05)。全麻組深靜脈血栓發(fā)生率明顯高于硬膜外組(P0.05)。結(jié)論硬膜外麻醉對高齡全膝關(guān)節(jié)置換術(shù)患者凝血功能影響小于全身麻醉,可有效減少術(shù)后深靜脈血栓的發(fā)生。
[Abstract]:Objective to observe the effects of general anesthesia and epidural anesthesia on coagulation function and complications of deep venous thrombosis in elderly patients undergoing total knee arthroplasty. Methods 80 elderly patients undergoing total knee arthroplasty were randomly divided into two groups. General anesthesia was selected in 40 patients in general anesthesia group and epidural anesthesia in 40 patients in epidural group. Before anesthesia (T1), 30 min (T2) after anesthesia, at the end of operation (T3), and 1 day after operation (T2), the mean arterial pressure (MAP), heart rate (HR), oxygen saturation [Sp (O 鈮，

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