全麻和腰硬联合麻醉用于髋关节置换术的疗效观察

General and waist hard joint anesthesia for curative effect observation of marrow joint replacement

目的探讨全麻和腰硬联合麻醉用于髋关节置换术(HR)的临床效果与安全性。方法将118例髋关节置换术患者随机分为两组,对照组59例采用气管插管全麻,观察组59例采用腰硬联合麻醉,比较两组的临床麻醉效果、血液动力学变化及安全性。结果观察组的总有效98.31%明显的高于对照组86.44%(χ2=8.573,P<0.05),观察组在麻醉诱导后、插管后即刻、术中(切皮时)、拔管时的HR、SPB、DPB均低于对照组(均P<0.05),观察组的麻醉用药剂量、感觉阻滞起效、阻滞完全时间以及苏醒时间均低于对照组(均P<0.05),观察组的术后并发症发生率明显低于对照组(均P<0.05)。结论腰硬联合麻醉用于髋关节置换术效果较好,安全、可靠,患者清醒时间较短,血液动力学稳定,并发症少,不良反应少,值得临床大力推广。

objective：to discuss the general and waist hard joint anesthesia used in the clinical effect and security of the hip joint replacement（HR）. Methods：118 patients with hip replacement were randomly divided into two groups,the control group in 59 patients with tracheal intubation anesthesia,observation group of 59 patients with waist hard joint anes-thesia,comparing two groups of clinical anesthesia effect,hemodynamic changes and security. Results：the total effective 98. 31% of observation group was obviously higher than the control group 86. 44%（chi - square = 8. 573,P 〈 0. 05）,the observation group after anesthesia induction,immediately after intubation,intraoperative（cut skin）,HR,spb extubation, DPB were lower than the control group（all P 〈 0. 05）,the observation group of dosage,sensory block anesthesia effect, block completely and awakening time were lower than control group（all P 〈 0. 05）,the incidence of postoperative compli-cations of observation group was obviously lower than that of control group（all P 〈 0. 05）. Conclusion the waist hard joint anesthesia for hip replacement effect is good,safe,reliable,relatively short waking hours,hemodynamic stability,fewer complications,less adverse reaction,is worth promoting in the clinical practice.