全麻与腰硬联合麻醉在老年患者股骨颈骨折手术的效果对比研究

Different anesthesia in elderly patients with femoral neck fracture surgery effect

目的对比观察全麻与腰硬联合麻醉在老年股骨颈骨折手术的效果。方法将2013年1月至2015年6月行股骨颈骨手术的124例患者,随机分成实验组和对照组,每组62例。对照组患者采取全身麻醉,实验组患者采取腰硬联合麻醉。观察两组患者:1术中不良反应:高血压、低血压、心动过缓发生率、缺氧发生率;2手术的麻醉效果;3肌肉松弛效果;4观察麻醉起效时间;5镇痛效果;6术后不良反应发生情况;7患者满意度。结果 1实验组患者的高血压、低血压发生率明显低于对照组,差异具有统计学意义(P<0.05);两组心动过缓、缺氧发生率比较,差异无统计学意义(P>0.05)。2实验组实麻醉总优良率高于对照组,差异有统计学意义(98.4%vs.85.5%,P<0.05)。3实验组手术中肌肉松弛效果总满意率高于对照组,差异有统计学意义(98.4%vs.83.9%,P<0.05)。4实验组麻醉起效时间明显短于对照组(P<0.05)。5实验组术后镇痛效果VAS评分明显小于对照组(P<0.05)。6实验组患者头晕嗜睡、恶心呕吐、肺部感染等发生率明显低于对照组(P<0.05)。7两组患者对手术的满意度比较差异无明显统计学意义(P>0.05)。结论与全身麻醉相比,在老年股骨颈骨折手术实施过程中应用腰硬联合麻醉,起效更快,镇痛效果更好,不良反应发生率更低,值得临床上推广应用。

Objective To study the different anesthetic methods on elderly patients with femoral neck fracture. Methods From January 2013 to June 2015 to the femoral neck bone surgery,124 patients were randomly divided into experimental group and the control group,62 cases in each group. Taken general anesthesia during the surgery,the control group,experimental group take the waist hard joint anesthesia. Indicators were observed,including 1 intraoperative adverse reactions： hypertension,hypotension,bradycardia incidence,the incidence of hypoxia; 2 anesthesia surgery; 3 muscle relaxant effect; 4 observe the onset time of anesthesia; 5 analgesia; 6postoperative adverse events; 7 patient satisfaction. Results 1 The experimental group of patients with hypertension,the incidence of hypotension was significantly lower than the control group,the difference was statistically significant（ P〈 0. 05）. The difference was not statistically significant in bradycardia,hypoxia incidence（P〉 0. 05）. 2 The total anesthesia real good rate in experimental group was higher,the difference was statistically significant（ 98. 4% vs. 85.5%,P〈 0. 05）. 3The experimental surgery muscle relaxation effect overall satisfaction rate was higher,the difference was statistically significant（ 98. 4% vs. 83. 9%,P〈 0. 05）. 4 The onset time of anesthesia in the experimental group was significantly shorter than that of the control group（ P〈 0. 05）. 5 The postoperative analgesia VAS scores of experimental group were significantly lower than the control group（ P〈 0. 05）. 6The experimental group were dizziness,drowsiness,nausea,vomiting,pulmonary infection. The rate was significantly lower than the control group（ P〈 0. 05）. 7 The difference in satisfaction with the surgery two groups of patient was not statistically significant（ P〉0. 05）. Conclusion The waist hard joint anesthesia is better than general anesthesia. This method is suitable for the implementation of the elderly femoral neck fracture surgery,it have the lower incidence of adverse,analgesic effect is better. This method is worthy of clinical popularization and application.