临床分析高龄关节置换术中全麻和硬膜外麻醉的麻醉效果

Anesthesia Effect of General Anesthesia and Epidural Anesthesia in Elderly Patients with Total Hip Replacement

目的比较高龄关节置换术中全麻和硬膜外麻醉的临床应用效果。方法采用回顾性方法分析,选取我院2013年1月-2014年12月间在我院行髋关节置换术的85例患者,按麻醉方案分为全麻组（40例）和硬膜外麻醉组（45例）,比较两组不同时间点的凝血功能指标及术后24 h、72 h简易精神状态量表（MMSE）评分。结果硬膜外麻醉组D-二聚体水平在麻醉后6 h以及术后第l天清晨显著低于全麻组,患者麻醉24 h MMSE评分明显高于全麻组,差异有统计学意义（P〈0.05）。结论高龄关节置换术中实施硬膜外麻醉对患者认知功能影响小,且可维持稳定的凝血功能状态,临床应用价值显著。

Objective To compare the clinical effect of general anesthesia and epidural anesthesia in elderly patients with total hip replacement. Methods A retrospective analysis was performed on 85 patients who underwent total hip arthroplasty in our hospital from January December to 2013. The patients were divided into general anesthesia group（ 40cases） and epidural anesthesia group（ 45 cases）,and compared with the two groups（ cases）. The coagulation function index and 72 h,24h simple mental state scale（ MMSE） score were compared between the two groups. Results The levels of D- two in epidural anesthesia group were significantly lower than those in the general anesthesia group（ L 6）,and the difference was statistically significant（ P 〈0. 05）. Conclusions The effect of epidural anesthesia in elderly patients with joint replacement is small,and it can maintain the stability of blood coagulation function,and the clinical application value is significant.