摘要
目的:探讨腰-硬联合麻醉对老年股骨颈骨折内固定术患者机体血流动力学及术后短期认知功能的影响。方法:选取2017年1月-2019年6月本院收治的79例老年股骨颈骨折内固定术患者为研究对象,按照随机数字表法将其分为对照组38例及观察组39例。对照组采用全身麻醉,观察组采用腰-硬联合麻醉,比较两组麻醉起效时间、意识恢复时间、完全清醒时间、麻醉后镇静评分(Ramsay)、平均动脉压(MAP)、心率(HR)、认知功能评分(MMSE)、麻醉相关并发症。结果:观察组麻醉起效时间、意识恢复时间、完全清醒时间均短于对照组,麻醉后Ramsay评分高于对照组,差异均有统计学意义(P<0.05)。手术0.5 h、术后即刻,观察组的MAP均高于对照组,HR均低于对照组,差异均有统计学意义(P<0.05)。麻醉前、麻醉结束72 h,两组MMSE评分比较,差异均无统计学意义(P>0.05);麻醉结束12、24 h,观察组的MMSE评分均高于对照组,差异均有统计学意义(P<0.05)。观察组麻醉相关并发症发生率为12.82%,低于对照组的39.47%,差异均有统计学意义(P<0.05)。结论:腰-硬联合麻醉起效时间短、麻醉后恢复快,镇静效果显著,并能够维持患者机体血流动力学稳定,减轻术后短期认知功能障碍,且并发症少。
Objective:To investigate the effect of combined spinal epidural anesthesia on hemodynamics and postoperative short-term cognitive function in elderly patients with femoral neck fracture internal fixation.Method:Seventy-nine elderly patients with femoral neck fractures treated in our hospital from January 2017 to June 2019 were selected as the research objects.According to the random number table method,they were divided into control group 38 cases and observation group 39 cases.The control group was given general anesthesia,the observation group was given combined spinal epidural anesthesia.Anesthesia onset time,consciousness recovery time,complete awake time,postoperative sedation score(Ramsay),mean arterial pressure(MAP),heart rate(HR),cognitive function score(MMSE),anesthesia related complications were compared between the two groups.Result:The onset time,consciousness recovery time and full consciousness time of the observation group were shorter than those of the control group,the Ramsay score after anesthesia was higher than that of the control group,with statistically significant differences(P<0.05).0.5 h after surgery and immediately after surgery,MAP of the observation group were higher than those of the control group,HR were lower than those of the control group,the differences were statistically significant(P<0.05).Before anesthesia,the anesthesia was over for 72 hours,there was no significant difference in MMSE scores between the two groups(P>0.05).At 12 and 24 h after anesthesia,MMSE scores of the observation group were higher than those of the control group,with statistically significant differences(P<0.05).The incidence of anaesthesia related complications in the observation group was 12.82%,lower than 39.47%in the control group the difference was statistically significant(P<0.05).Conclusion:Combined spinal epidural anesthesia has the advantages of short onset time,rapid recovery after anesthesia,significant sedation effect,and can maintain the stability of hemodynamics of patients,reduce short-ter
作者
王传福
WANG Chuanfu(Jiamusi Central Hospital,Jiamusi 154002,China)
出处
《中国医学创新》
CAS
2020年第22期9-13,共5页
Medical Innovation of China
关键词
腰-硬联合麻醉
股骨颈骨折内固定
血流动力学
认知功能
Combined spinal epidural anesthesia
Internal fixation of femoral neck fracture
Hemodynamics
Cognitive function
