摘要
目的比较利多卡因联合左旋布比卡因局部麻醉与全身麻醉对老年无骨折脱位型颈脊髓损伤的手术疗效。方法选取2008年2月至2013年5月医院就诊的老年无骨折脱位型颈脊髓损伤患者106例,依据分层随机分组法将患者分为局部麻醉组(A组)及全身麻醉组(B组),各53例。A组采用利多卡因联合左旋布比卡因进行局部麻醉下行手术治疗;B组采用常规全身麻醉下行手术治疗。结果两组患者治疗前的日本骨科协会(JOA)颈椎评分及颈部前后活动度比较差异无统计学意义。A组术中神经损伤、术后呼吸道不适例数及住院时间分别为0例、0例、(7.59±0.97)d,明显低于B组的4例、6例、(8.07±1.05)d(P<0.05);术后、术后2个月及术后半年A组JOA颈椎评分分别为(8.26±2.17)分、(12.31±2.64)分、(14.18±3.54)分,颈部前后活动度(30.14±7.08)°、(32.83±8.47)°、(34.11±8.97)°,均明显优于B组的JOA颈椎评分(7.04±1.83)分、(10.69±2.30)分、(12.38±3.09)分,颈部前后活动度(27.04±7.59)°、(29.15±8.17)°、(30.29±8.68)°(P<0.05);术后A组患者治疗总满意度为98.11%,明显高于B组的88.68%(P<0.05)。结论利多卡因联合左旋布比卡因局部麻醉下对老年无骨折脱位型颈脊髓损伤患者行手术治疗的临床疗效明显优于全身麻醉下行手术治疗。
Objective To compare the operative efficacy of topical anesthesia of lidocaine combined with levobupivacaine and general anesthesia in the elderly patients with cervical spinal cord injury without fracture and dislocation. Methods 106 elderly patients with cervical spinal cord injury without fracture and dislocation admitted to our hospital from February 2008 to May 2013 were divided into the local anesthesia group （ group A） and general anesthesia group （ group B ） according to the stratified randomization method,53 cases in each group. The group A adopted the local anesthesia of lidocaine combined with levobupivacaine for performing operation,while the group B were performed the operation under the routine general anesthesia. Results The Japanese Orthopaedic Association（JOA）cervi-cal vertebral score and the anterior and posterior mobility of the neck in the two groups had no statistically significant difference before surgical treatment;The case number of intraoperative nerve damage,postoperative respiratory tract discomfort and the hospital stay in the group A were 0 case,o cases and（7. 59 ± 0. 97）d,which were significantly lower than 4 cases,6 cases and（8. 07 ± 1. 05）d in the group B（ P 〈 0. 05）;the JOA cervical spine scores after operation,postoperative 2 months and postoperative half year in the group A were （8. 26 ± 2. 17） points,（12. 31 ± 2. 64） points,（14. 18 ± 3. 54） points,and the anterior and posterior mobility of the neck was （30. 14 ± 7. 08）°,（32. 83 ± 8. 47）°,（34. 11 ± 8. 97）°,which were significantly better than（7. 04 ± 1. 83）points,（10. 69 ± 2. 30）points, （12. 38 ± 3. 09） points,（27. 04 ± 7. 59）°,（29. 15 ± 8. 17）° and （30. 29 ± 8. 68）° in the group B （ P 〈 0. 05）;the postoperative total satisfaction in the group A was 98. 11%,which was significantly higher than 88. 68% in the group B（ P 〈 0. 05）. Conclusion The surgical treatment under the topical anesthesia of lidocaine combined with levobup
出处
《中国药业》
CAS
2014年第20期29-31,共3页
China Pharmaceuticals
关键词
老年
无骨折脱位型颈脊髓损伤
局部麻醉
利多卡因
左旋布比卡因
elderly
cervical spinal cord injury without fracture and dislocation
topical anesthesia
lidocaine
levobupivacaine
