轻比重腰麻与全身麻醉在老年患者人工股骨头置换术中的应用效果分析

The effect analysis of hypobaric spinal anesthesia and general anesthesia in elderly patients treated with artificial femoral head replacement

目的：观察分析布比卡因轻比重腰麻与全身麻醉在老年人工股骨头置换术中的应用效果。方法：36例ASAⅠ~Ⅲ级接受人工股骨头置换手术的老年患者,年龄60~84岁,排除未控制的心衰、肺炎、肺不张等,分为2组,A组为布比卡因轻比重腰麻组,B组为全麻组。比较2组患者的出血量、术后患肢运动功能恢复时间、术后肺部并发症、住院时间及住院总费用。结果：A组患者在出血量和肺部并发症与B组差异无统计学意义（P〉0.05）,下肢运动功能恢复时间长于B组患者（P〈0.01）,而住院时间和住院总费用均明显低于B组患者（P〈0.01）。结论：控制好麻醉平面,细心管理患者,布比卡因轻比重腰麻较全身麻醉更加适用于老年人工股骨头置换手术,是一种很好的麻醉方式。

Objective：To compared the effects of hypobaric spinal anesthesia and general anesthesia in elderly patients treated with artificial femoral head replacement. Methods：Thirty-six elderly patients with ASAⅠ to Ⅲ treated with artificial femoral head replacement,without uncontrolled heart failure,pneumonia and atelectasis,were randomly divided into the bupivacaine hypobaric spinal anesthesia group （ group A ） and general anesthesia group （ group B ） . The amount of bleeding, recovery time of limb function, postoperative pulmonary complications,hospital stay and total hospitalization expense between two groups were compared. Results：The differences of the amount of bleeding and postoperative pulmonary complications between two groups were not significant（P〉0. 05）. The motor function recovery time of lower limb in group A was longer than that in group B（P 〈0. 01）,the hospital stay and total hospitalization expense in group A were lower than those in group B（P 〈0. 01）. Conclusions：Hypobaric spinal anesthesia with bupivacaine is more suitable for the elderly patients treated with artificial femoral head replacement,which is a good anesthesia way.