摘要
目的探究小剂量轻比重腰-硬联合麻醉和股神经及坐骨神经阻滞麻醉在老年创伤性下肢骨折(TLEF)患者内固定术中的应用效果。方法随机选取南阳市中心医院在2020年5月至2022年5月收治的80例老年TLEF患者作为本次研究对象,用随机数字法将其分为对照组(40例)和研究组(40例)。两组患者均行内固定术治疗,对照组术中行小剂量轻比重腰-硬联合麻醉;研究组术中行股神经及坐骨神经阻滞麻醉。比较两组麻醉效果、生命体征变化、凝血功能、术后不良反应、术后恢复情况。结果两组麻醉起效时间、完全麻醉时间、感觉神经完全麻醉时间、运动神经完全麻醉时间比较,差异无统计学意义(P>0.05)。麻醉后,两组心率(HR)和平均动脉压(MAP)水平均低于麻醉前(P<0.05),两组麻醉后HR和MPA水平比较,差异无统计学意义(P>0.05)。术后,两组凝血酶时间(TT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)水平均高于术前,研究组高于对照组(P<0.05),两组纤维蛋白原(FIB)水平低于术前,研究组低于对照组(P<0.05)。两组术后不良反应差异无统计学意义(P>0.05)。研究组术后苏醒时间、拔管时间、下肢运动恢复时间及排尿恢复时间均低于对照组(P<0.05)。结论老年TLEF患者内固定术中接受小剂量轻比重腰-硬联合麻醉和股神经及坐骨神经阻滞麻醉均有较好麻醉效果,但股神经及坐骨神经阻滞麻醉可明显减轻血液高凝状态,减少麻醉不良反应,有效促进患者术后恢复。
Objective To investigate the application of low-dose light specific weight combined lumbar hard anesthesia and anesthesia with femoral nerve and sciatic nerve block for internal fixation in elderly patients with traumatic lower extremity fractures(TLEF).Methods Eighty elderly patients with TLEF who were admitted to Nanyang Central Hospital from May 2020 to may 2022 were randomly selected for this study.They were equally divided into a control group(forty cases)and a study group(forty cases)using a random number method.Both groups of patients were treated with internal fixation.The control group received low dose light specific gravity combined spinal epidural anesthesia during operation.The study group received intraoperative femoral and sciatic nerve block anesthesia.the anesthesia effects,changes in vital signs,coagulation function,postoperative adverse reactions and complications,and postoperative recovery were compared between the two groups.Results There were no differences between the two groups in terms of onset time,total anesthesia time,sensory nerve total anesthesia time,and motor nerve total anesthesia time(P>0.05).After anesthesia,the levels of heart rate(HR)and mean arterial pressure(MAP)in both groups were lower than before anesthesia(P<0.05).There were no differences in HR and MPA levels between the two groups after anesthesia(P>0.05).After surgery,the levels of thrombin time(TT),prothrombin time(PT)and activated partial thromboplastin time(APTT)in both groups were higher than those before surgery,while those in the study group were higher than those in the control group(P<0.05),the levels of fibrinogen(FIB)in the two groups were lower than those before surgery,while those in the study group were lower than those in the control group(P<0.05).There was no difference in postoperative adverse reactions between the two groups(P>0.05).The postoperative recovery time,extubation time,lower limb movement recovery time and urination recovery time in the study group were lower than those in the control group
作者
杜治昆
司小萌
王卓
裴金乐
DU Zhikun;SI Xiaomeng;WANG Zhuo;PEI Jinle(Emergency Trauma Surgery Department,Nanyang Central Hospital,Nanyang 473000,China;Surgery Department,Nanyang Central Hospital,Nanyang 473000,China;Western Medicine and Pharmacy Department,Nanyang Central Hospital,Nanyang 473000,China;Bone,Joint,Hand,and Foot Surgery Department,Nanyang Central Hospital,Nanyang 473000,China)
出处
《河南医学研究》
CAS
2024年第14期2580-2584,共5页
Henan Medical Research
关键词
创伤性下肢骨折
内固定术
小剂量轻比重腰-硬联合麻醉
股神经及坐骨神经阻滞麻醉
麻醉效果
traumatic lower limb in the elderly
internal fixation
low dose light specific gravity combined spinal epidural anesthesia
femoral and sciatic nerve block anesthesia
anesthetic effect
