不同麻醉方式应用于人工全髋关节置换术的临床效果观察

Clinical efficacy of different anesthetic used in total hip arthroplasty

目的:探讨并比较全麻及腰硬联合麻醉应用于人工全髋关节置换术的临床效果以及不良反应。方法:选择64例行人工全髋关节置换术的患者,将其具体依照随机数字法分为A组(腰硬联合麻醉32例)和B组(气管插管全麻32例),对两组的麻醉效果、麻醉后不良反应以及血液动力学情况进行比较分析。结果:①在麻醉诱导后、行气管插管后即刻、切皮阶段以及拔出气管导管时等不同时段,A组的心率、血压与B组比较其差异有统计学意义(t=4.036,t=5.227,t=6.003;P<0.05);②A组的麻醉用药量、阻滞起效、麻醉效果以及阻滞完全时间4方面与B组比较,其差异有统计学意义(t=3.977,t=4.956,t=7.328,t=6.887;P<0.05);③术后镇痛比较,A组要优于B组(x2=22.337,P<0.05);④不良反应发生率比较,A组则显著低于B组(x2=15.321,P<0.05)。结论:腰硬联合麻醉应用于人工全髋关节置换术的临床效果较好,且不良反应较少,同时患者的血液动力学相对稳定,可在医院推广应用。

Objective：To explore and compare anesthesia and lumbar epidural anesthesia used in total hip arthroplasty clinical effects and adverse reactions. Methods：To choose the 64 cases of total hip arthroplasty patients in our hospital, specifically in accordance with the random number divided into group A （lumbar epidural anesthesia, general anesthesia 32 cases） and group B （32 patients）anesthetic effect of the two groups, adverse reactions after anesthesia and hemodynamic comparative analysis. Results：At different times of the day, after induction of anesthesia, immediately after endotracheal intubation, incision stage, pull out the endotracheal tube, A group of heart rate, diastolic blood pressure （DPB） and systolic blood pressure （SPB） compared with group B, significantly higher thansmall, the differences between treated by the statistical test was statistically significant （t=4.036, 5.227, 6.003, P〈0.05）, anesthesia dosage studies A group of block onset anesthetic effect and block completely, and B group, a significant advantage statistical analysis, the difference was statistically significant （t=3.977, 4.956, 7.328, 6.887, P〈0.05） in postoperative analgesia, A group to be significantly better than in group B （x2=22.337, P〈0.05）, incidence of adverse reactions. A group was significantly lower than in group B（x2=15.321, P〈0.05）. Conclusion：Combined spinal-epidural anesthesia in total hip arthroplasty good clinical results and fewer adverse reactions, and the patient＆#39;s hemodynamic relatively stable, at the hospital, the popularization of application.