摘要
目的探讨椎管内麻醉对老年下肢骨折患者术后应激反应及深静脉血栓发生率的影响。方法收集2019年6月至2021年6月武汉市第三医院收治的80例老年下肢骨折患者的临床资料,根据麻醉方式的不同将其分为对照组(采取全身麻醉的方式)和观察组(采取椎管内麻醉的方式),每组40例,均进行了手术治疗。比较两组患者的手术一般情况(住院时间、手术时间、留观时间及术中出血量)、手术前后应激反应指标[皮质醇(Cor)、心房钠尿肽(ANP)、肾上腺素(epinephrine,E)及去甲肾上腺素(NE)]、血流动力学指标[心率(HR)和平均动脉压(MAP)]及术后并发症(恶心呕吐、头痛、下肢深静脉血栓、低血压)发生情况。结果观察组患者的住院时间、留观时间均短于对照组患者(P<0.05)。术后,观察组患者的Cor、ANP、E、NE水平均明显低于对照组患者(P<0.01)。术后,观察组患者的HR、MAP均高于对照组患者(P<0.05)。观察组患者的术后并发症发生率低于对照组患者(P<0.05)。结论椎管内麻醉有利于改善老年骨折患者的临床指标,减少对术后应激反应及血流动力学的影响,降低深静脉血栓等并发症的发生率。
Objective To investigate the effect of spinal anesthesia on postoperative stress response and incidence rate of deep vein thrombosis in elderly patients with lower extremity fracture.Method The clinical data of 80 elderly patients with lower extremity fractures admitted to Wuhan Third Hospital from June 2019 to June 2021 were collected.The patients were divided into control group(general anesthesia)and observation group(spinal anesthesia)according to different anesthesia methods,with 40 cases in each group.All patients underwent surgery.The general conditions(hospitalization time,surgery time,observation time,intraoperative blood loss),stress response indicators[cortisol(Cor),atrial natriuretic peptide(ANP),epinephrine(E),noradrenaline(NE)]before and after the surgery,hemodynamics indicators[heartrate(HR),mean arterial pressure(MAP)],and postoperative complications(nausea and vomiting,headache,deep vein thrombosis of lower extremity,hypotension)were compared between the two groups.Result The hospitalization time and observation time of the observation group were shorter than those of the control group(P<0.05).After the operation,the levels of Cor,ANP,E and NE in the observation group were significantly lower than those in the control group(P<0.01).After the operation,the HR and MAP of the observation group were higher than those of the control group(P<0.05).The incidence rate of postoperative complications in the observation group was lower that in the control group(P<0.05).Conclusion Spinal anesthesia is beneficial to improve the clinical indicators of elderly fracture patients,reduce the impact on postoperative stress response and hemodynamics,and reduce the incidence of complications such as deep vein thrombosis.
作者
汪刚
胡光俊
熊苗
Wang Gang;Hu Guangjun;Xiong Miao(Department of Anesthesiology,Wuhan Third Hospital,Wuhan 430000,Hubei,China;Department of Intervention,Wuhan Third Hospital,Wuhan 430000,Hubei,China)
出处
《血管与腔内血管外科杂志》
2022年第8期1013-1016,共4页
Journal of Vascular and Endovascular Surgery
关键词
椎管内麻醉
老年
骨折
应激反应
深静脉血栓
效果
spinal anesthesia
elderly
fracture
stress response
deep vein thrombosis
effect
