腰硬联合麻醉和静脉全身麻醉方法用于老年患者髋部手术的优缺点

Combined spinal-epidural anesthesia and intravenous anesthesia for elderly patients with hip operation advantages and disadvantages

目的：分析老年患者在实施髋部手术时选择静脉全身麻醉与选择腰硬联合麻醉的优势及不足.方法：在2011 年需实施髋部手术的病例中抽取63 例老年患者,麻醉时随机选择静脉全麻方式（静脉组）或者腰硬联合麻醉方式（腰硬组）,各组分别有患者31 例、32 例.统计实施麻醉操作时有痛感的患者占比,监测不同操作时患者的心率和血压.结果：静脉组实施麻醉操作时有痛感的患者占比为29.0%（9 例）,腰硬组实施麻醉操作时有痛感的患者占比为62.5%（20 例）,（P〈0.05） 差异性显著;手术操作过程中腰硬组比静脉组监测指标数值略低（P〈O.05）,但未偏离正常水平,1 日后两组监测指标数值相近.结论 ;老年患者在实施髋部手术时应合理选择静脉全身麻醉与腰硬联合麻醉两种方法.

Objective： to analysis of elderly patients in the implementation of hip operation is selected when the intravenous anesthesia and combined spinal-epidural anesthesia advantages and disadvantages. Methods： in 201 lfor a hip operation cases selected 63 cases elderly patients, anesthesia, intravenous anesthesia method random selection （ vein group ） or combined spinal-epidural anesthesia methods （ lumbar epidural group ）,31 patients in each group respectively,32 cases. Statistical anesthesia during operation pain patients accounted, monitoring of different operation in heart rate and blood pressure. Results： venous group implements the anaesthesia operation painful patients accounted for 29% （9 cases）, spinal and epidural anesthesia in operation group of pain patients accounted for 62.5% （20 cases）, （ P 〈 0.05） a significant difference; the operation process of lumbosacral group than the vein group monitoring index slightly low （ P 〈 O.05）, but has not deviated from the normal level after 1, two groups of indicators for monitoring numerical values are similar. Conclusion; in elderly patients with hip operation in the implementation should be a reasonable choice of intravenous general anesthesia and combined spinal-epidural anesthesia with two methods.