分析不同麻醉方案对髋关节置换术老年患者血流动力学的影响(1)
[摘要] 目的 分析不同麻醉方案对髋关节置换术老年患者血流动力学的影响。方法 方便择取2015年1月—2016年5月长春中医药大学附属医院收治的髋关节置换术老年患者84例，将其均分为研究组与对照组。研究组应用腰硬联合麻醉，对照组应用气管插管-静吸全麻。观察对比不同手术时间两组患者血流动力学的变化。结果 研究组填充骨水泥后、缝皮时及完成手术时HR(72.5±10.3)次/min、(73.5±10.2)次/min、(74.3±15.5)次/min，低于对照组(82.5±10.5)次/min、(83.5±10.2)次/min、(84.2±10.3)次/min(P<0.05)，DBP(77.5±8.2)mmHg、(78.6±9.2)mmHg、(78.6±8.6)mmHg与SBP(125.5±17.5)mmHg、(127.5±15.5)mmHg、(126.6±15.8)mmHg高于对照组(70.5±7.7)mmHg、(70.4±8.7)mmHg、(71.1±10.5)mmHg与(115.5±12.5)mmHg、(113.5±17.5)mmHg、(118.5±14.5)mmHg(P<0.05)。结论 腰硬联合麻醉可以有效保证髋关节置换术老年患者血流动力学的稳定性，适于临床应用。
[关键词] 不同麻醉；髋关节置换术；老年；血流动力学
[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742(2017)01(b)-0039-03
[Abstract] Objective To analyze the effect of different anesthetic plans on hemodynamics of senile patients with hip replacement. Methods Convenient selection 84 cases of senile patients with hip replacement treated in the Affiliated Hospital of Changchun University of Traditional Chinese Medicine from January 2015 to May 2016 were selected and divided into two groups， the research group adopted the combined spinal and epidural anesthesia， while the control group adopted the tracheal cannulation and Intravenous Inhalation Anesthesia， and the changes of hemodynamics of the two groups were observed at different operative time. Results The HR after filling with the bone cement， at the time of skin closure and completing the operation in the research group was lower than that in the control group，[(72.5±10.3)times/min，(73.5±10.2)times/min， (74.3±15.5)times/min vs (82.5±10.5)times/min， (83.5±10.2)times/min， (84.2±10.3)times/min]， the DBP and SBP in the research group was higher than that in the control group， [(77.5±8.2)mmHg， (78.6±9.2)mmHg， (78.6±8.6)mmHg vs (70.5±7.7)mmHg， (70.4±8.7)mmHg， (71.1±10.5)mmHg]， [(125.5±17.5)mmHg，(127.5±15.5)mmHg， (126.6±15.8)mmHg vs (115.5±12.5)mmHg， (113.5±17.5)mmHg，(118.5±14.5)mmHg](P<0.05). Conclusion The combined spinal and epidural anesthesia can effectively ensure the stability of hemodynamics of senile patients with hip replacement， which is suitable for clinical application.
[Key words] Conclusion Different anesthesia； Hip replacement； Senile； Hemodynamics
髖关节置换术属于老年群体的常见骨科术式，具有失血量多、刺激性强、术后并发症多等特点，加之老年人群机体功能衰弱，不仅显著增加了手术的风险，同时也对手术麻醉方式提出了较高的要求[1-2]。为了完善骨科临床麻醉方案，2015年1月—2016年5月该院对84例髋关节置换术老年患者分别应用了气管插管-静吸全麻与腰硬联合麻醉，对比两组麻醉方法对血流动力学的影响，现报道如下。
1 资料与方法
1.1 一般资料
方便择取该院收治的髋关节置换术老年患者84例。入组标准：具有相关手术指征；患者对该次研究内容知情。排除标准：合并严重肝肾功能障碍；脊柱疾病；精神疾病；意识障碍。以随机数字表将84例患者均分为两组，即研究组与对照组各42例。对照组：男22例，女20例；年龄60～78岁，平均(70.5±5.3)岁；手术时间在70～140 min，平均(84.5±10.5)min。对照组：男23例，女19例；年龄60～78岁，平均(70.6±5.5)岁；手术时间在70～140 min，平均(84.8±11.8)min。两组患者在性别、年龄及手术时间比较中差异无统计学意义(P>0.05)。, 百拇医药(王凤娟 吴振忠)
[关键词] 不同麻醉；髋关节置换术；老年；血流动力学
[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742(2017)01(b)-0039-03
[Abstract] Objective To analyze the effect of different anesthetic plans on hemodynamics of senile patients with hip replacement. Methods Convenient selection 84 cases of senile patients with hip replacement treated in the Affiliated Hospital of Changchun University of Traditional Chinese Medicine from January 2015 to May 2016 were selected and divided into two groups， the research group adopted the combined spinal and epidural anesthesia， while the control group adopted the tracheal cannulation and Intravenous Inhalation Anesthesia， and the changes of hemodynamics of the two groups were observed at different operative time. Results The HR after filling with the bone cement， at the time of skin closure and completing the operation in the research group was lower than that in the control group，[(72.5±10.3)times/min，(73.5±10.2)times/min， (74.3±15.5)times/min vs (82.5±10.5)times/min， (83.5±10.2)times/min， (84.2±10.3)times/min]， the DBP and SBP in the research group was higher than that in the control group， [(77.5±8.2)mmHg， (78.6±9.2)mmHg， (78.6±8.6)mmHg vs (70.5±7.7)mmHg， (70.4±8.7)mmHg， (71.1±10.5)mmHg]， [(125.5±17.5)mmHg，(127.5±15.5)mmHg， (126.6±15.8)mmHg vs (115.5±12.5)mmHg， (113.5±17.5)mmHg，(118.5±14.5)mmHg](P<0.05). Conclusion The combined spinal and epidural anesthesia can effectively ensure the stability of hemodynamics of senile patients with hip replacement， which is suitable for clinical application.
[Key words] Conclusion Different anesthesia； Hip replacement； Senile； Hemodynamics
髖关节置换术属于老年群体的常见骨科术式，具有失血量多、刺激性强、术后并发症多等特点，加之老年人群机体功能衰弱，不仅显著增加了手术的风险，同时也对手术麻醉方式提出了较高的要求[1-2]。为了完善骨科临床麻醉方案，2015年1月—2016年5月该院对84例髋关节置换术老年患者分别应用了气管插管-静吸全麻与腰硬联合麻醉，对比两组麻醉方法对血流动力学的影响，现报道如下。
1 资料与方法
1.1 一般资料
方便择取该院收治的髋关节置换术老年患者84例。入组标准：具有相关手术指征；患者对该次研究内容知情。排除标准：合并严重肝肾功能障碍；脊柱疾病；精神疾病；意识障碍。以随机数字表将84例患者均分为两组，即研究组与对照组各42例。对照组：男22例，女20例；年龄60～78岁，平均(70.5±5.3)岁；手术时间在70～140 min，平均(84.5±10.5)min。对照组：男23例，女19例；年龄60～78岁，平均(70.6±5.5)岁；手术时间在70～140 min，平均(84.8±11.8)min。两组患者在性别、年龄及手术时间比较中差异无统计学意义(P>0.05)。, 百拇医药(王凤娟 吴振忠)