两种麻醉方法对下肢外周动脉疾病血管重建术麻醉并发症影响的研究

Research on the effects of two kinds of anesthesia method on anesthesia complications of vascular revascularization in patients with lower extremity peripheral arterial disease

目的研究比较两种麻醉方法对下肢外周动脉疾病(PAD)血管重建术麻醉并发症的影响。方法将200例PAD患者分为两组,A组采用椎管内麻醉,B组采用全身麻醉,记录两组在围手术期麻醉并发症的发生情况,采用SPSS13.0进行数据的整理及分析。结果在术后一般麻醉并发症和严重并发症两项指标上,A组的发生比例都明显低于B组(P<0.05);用多因素Logistic回归分析得出,年龄和麻醉方法都是围手术期麻醉并发症的独立危险因素,两者的OR值分别是1.08(95%CI1.02～1.13)和205.84(95%CI57.70～734.11),均P<0.05。病变范围是围手术期严重并发症的重要危险因素,OR值是3.86(95%CI1.31～11.36)。结论在下肢PAD血管重建术中,椎管内麻醉引起的并发症低于全身麻醉。

Objective To compare the two anesthesia methods to the iniluence of anaesthetic complications during lower extremity revascularization （LER） in patients with peripheral arterial disease （PAD）. Methods 200 patients scheduled tbr LER were divided in intraspinal anesthesia group （A） and general anesthesia group （ B ）. The anaesthetic complications of patients during and after the operation in the two groups were recorded . SPSS 13.0 was selected to do data analysis. Results Patients in group A were much less likely to get general anaesthetic complications after the operation or serious complications during and after the LER （P 〈 0. 05 ）. The multiple logistic regression analysis revealed that the important risk factors of anaesthetic complications during and after the operation were age （OR：I. 08,95% CI： 1.02 - 1.13 ）and the way of anesthesia （0R：205.84,95% CI：57. 70 - 734. 11 ）. The range of the vascular lesion was considered to be the independent risk factor of serious complications during and after the LER（ OR ：3.86,95% CI： 1.31 -11.36 ）. Conclusions When it comes to LER for PAD patients, we＇d rather choose intraspinal anesthesia than general for the former alternative would lead fewer complications .