摘要
目的探讨80岁以上高龄患者行下肢骨科手术应用外周神经阻滞联合静脉快通道麻醉的效果。方法方便选取2016年7月—2017年12月期间在该院行下肢骨科手术且年龄在80岁以上的患者92例,按照麻醉方法不同,分为对照组(n=46)和观察组(n=46),对照组实施气管插管静脉麻醉,观察组应用外周神经阻滞联合静脉快通道麻醉,观察两组患者血流动力学情况,记录患者的拔管时间、呼吸恢复时间以及彻底清醒时间,并于术前、术后3 d、术后7 d对两组患者的认知功能进行统计。结果观察组患者的拔管时间、呼吸恢复时间以及彻底清醒时间明显低于对照组[分别为(8.57±3.39)min vs(21.45±3.34)min,t=18.36,P<0.05;(8.12±2.05)min vs(19.17±2.34)min,t=24.09,P<0.05;(15.47±2.56)min vs(28.26±2.37)min,t=24.87,P<0.05];观察组患者血流动力学情况优于对照组[心率:(82.12±6.05)次/min vs(89.17±6.34)次/min,t=5.46,P<0.05;舒张压:(81.47±12.39)mm Hg vs(115.45±11.34)mm Hg,t=13.72,P<0.05;收缩压:(131.47±15.56)mm Hg vs(165.26±15.37)mm Hg,t=10.48,P<0.05];术后3 d和7 d,观察组的认知功能评分都明显高于对照组[术后3 d:(25.57±2.39)分vs(21.45±2.34)分,t=8.35,P<0.05;术后7 d:(26.07±2.06)分vs(24.26±1.37)分,t=4.96,P<0.05];两个组别患者不良反应发生情况差异无统计学意义(P>0.05)。结论 80岁以上高龄患者下肢行骨科手术时应用外周神经阻滞联合静脉快通道麻醉,能够保持患者的血流动力学稳定,减小对心血管的影响和认知功能的影响,值得推广。
Objective To investigate the effect of lower limb orthopedic surgery on elderly patients over 80 years of age using peripheral nerve block combined with venous fast channel anesthesia. Methods From July 2016 to December 2017, 92 patients with orthopedic surgery in the lower limbs of the hospital aged 80 and over were convenient divided into control group（n=46） and observation group（n=46） according to different anesthetic methods. The control group was subjected to tracheal intubation and intravenous anesthesia. The observation group was treated with peripheral nerve block combined with venous fast channel anesthesia. The hemodynamics of the two groups were observed. The patient＇s extubation time, respiratory recovery time, and complete awake time were recorded, and preoperative, postoperative 3 days, 7 days postoperatively,the cognitive function of the two groups of patients were counted. Results The time of extubation, respiration recovery, and total awake time were significantly lower in the observation group than in the control group [（8.57 ±3.39）min vs（21.45 ±3.34）min, t=18.36, P〈0.05;（8.12±2.05）min vs（19.17±2.34）min,t=24.09, P〈0.05;（15.47±2.56）min vs（28.26±2.37）min, t=24.87, P〈0.05]; Hemodynamics of the observation group were better than that of the control group [heart rate：（82.12±6.05）times/min vs（89.17 ±6.34）times/min, t =5.46, P〈0.05; diastolic blood pressure：（81.47 ±12.39）mm Hg vs（115.45 ±11.34）mm Hg, t=13.72, P〈0.05; systolic blood pressure：（131.47±15.56）mm Hg vs（165.26±15.37）mm Hg, t=10.48, P〈0.05]; The cognitive function scores of the observation group were significantly higher than those of the control group on the 3 rd and 7 th days after operation [3 days after operation：（25.57±2.39）points vs（21.75±2.34）points,t=8.35, P〈0.05; 7 days postoperatively：（26.07±2.06）points vs（24.26±1.37）pointst=4.96, P〈0.05]; there was no significant difference in adverse reactions between the two groups�
作者
上官明化
罗来凤
SHANGGUAN Ming-hua;LUO Lai-feng(Department of Anesthesiology,Fifth Clinical College,Fujian University of Traditional Chinese Medicine,Sanming Second Hospital,Yong＇an,Fujian Province,366000 China)
出处
《中外医疗》
2018年第22期43-46,共4页
China & Foreign Medical Treatment
关键词
下肢骨科手术
外周神经阻滞联合静脉快通道麻醉
高龄患者
Lower limb orthopedic surgery
Peripheral nerve block combined with venous fast channel anesthesia
Elderlypatients
