腰-硬联合麻醉在高海拔高龄患者髋关节置换术中的应用

Combined Spinal-epidural Anesthesia in the Senile Patients with Hypoxia Undergoing Hip Arthroplasty

探讨腰-硬联合麻醉及全身麻醉用于高海拔高龄低氧患者行人工髋关节置换的临床优势。分析2010年1月～2013年11月来我院进行人工髋关节置换术的高龄（年龄＞69岁）低氧患者86例，其中全麻31例，腰-硬联合麻醉55例，记录麻醉后5min、15min、30min及术毕血压、心率，术中低血压发生率，术后转ICU比例等指标。与全麻相比，腰-硬联合麻醉组血流动力学稳定、术中低血压发生率降低（P＜0．05）、入住ICU几率显著降低（P＜0．05）。在高海拔高龄低氧患者行人工髋关节置换术中采用腰-硬联合麻醉可以使患者麻醉效果突出，血流动力学平稳，安全有效，比全麻更有临床应用优势。

This study is to explore the clinical application advantage of combined spinal-epidural （CSE） anesthesia and general anesthesia for elderly patients with hypoxia in high altitudes undergoing hip arthroplasty .Total of eighty-six senile patients （age〉 69y ） with hypoxia in high altitudes undergone hip arthroplasty in our hospital from January 2010 to November 2013 were analyzed retrospectively .Of all patients ,31 cases were given general anesthesia ,and 55 were given CSE anesthesia .Parameters of blood pressure （BP） and heart rate （HR） at 5min ,15min and 30min after anesthesia and at end of surgery ,hypotension during operation ,and transmission to intensive care unit （ICU ） after surgeries of all patients were recorded .Compared with general anesthesia group ,the hemodynamics were stable in CSE group ,and also decreased ratio （P〈0 .05） of hypotension and administration to ICU in CSE anesthesia group .Combined spinal and epidural （CSE） anesthesia for hip arthroplasty in elderly patients with hypoxia in high altitudes has significant anesthetic effect ,stable hemodynamics ,safe and effective ,and is better utilization in clinical than those in general anesthesia .