坐骨神经联合阻滞麻醉和腰硬联合麻醉对于膝关节置换手术生命体征的影响

Effect of sciatic nerve block anesthesia combined with spinal epidural anesthesia on vital signs of knee joint replacement surgery

目的 探讨坐骨神经联合阻滞麻醉和腰硬联合麻醉对于膝关节置换手术生命体征的影响。方法 选取2013年8月~2016年8月期间衢州市第二人民医院收治的112例膝关节置换手术患者进行不同麻醉处理,随机分为试验组1和试验组2,每组各56例,试验组1进行坐骨神经联合阻滞麻醉处理,试验组2进行腰硬联合麻醉处理,比较2组患者阻滞后心率、血压等生命体征的变化。结果 麻醉后,试验组1的心率、血压变化等生命体征的变化明显比试验组2的生命体征变化稳定,差异有统计学意义（P〈0.05）;试验组1患者的不良反应发生率（8.9%）明显低于试验组2（26.8%）,差异有统计学意义（P〈0.05）。试验组1患者术后24 h MMSE评分（26.44±0.76）显著低于试验组2的（27.18±0.72）,差异有统计学意义（P〈0.05）;但2组患者麻醉前、术后6、24、72 h简易精神状态评价量表（MMSE）评分对比差异无统计学意义。结论 对膝关节置换手术的患者进行坐骨神经联合阻滞麻醉处理后患者的生命体征变化稳定,而且不良反应少,更适合膝关节置换手术麻醉处理。

Objective To investigate the effects of sciatic nerve combined with anesthesia and lumbar spinal combined anesthesia on the vital signs f knee replacement surgery. Methods 112 c a s e s of knee joint replacement s u r g e r y with different anesthesia , in The second peopled H o s p i t a l o f Quzhou rom August 2013 to August 2015, were s e l e cted and randomly divided into experimental group one and experimental group two, 56 c a s e s in e a c h group. xperimental group one was treated with sciatic nerve combined with anesthesia, and experimental group two underwent combined spinal-epidural nesthesia, comparison of changes in vital signs, blood pressure and other vital signs after 2 groups. Results A f t e r a n e s t h e s i a , the c h a n g e s of vital signs uch as heart rate and blood pressure of experimental group one was significantly higher than that of experimental group two, the difference was tatistically significant （ P 〈 0. 05 ）. The incidence o f adverse events in t he experimental group one was significantly lower than that in the experimental roup two （26. 8% ） , the difference was statistically significant （ P 〈 0. 05 ）. T h e MMSE s c o r e in the e x p e r i m e n t a l g r o u p o n e （26. 44 ±0.76） w a s ignificantly lower than that of the experimental group two （27. 18 ±0. 7 2）,t h e difference w a s statistically significant （P 〈0. 05）. H o w e v e r , t h ere w a s o significant difference in MMSE score between the two groups before anesthesia, 6 h o u r s , 24 h o u r s a n d 72 h o u r s after operation. Conclusion Patients ith knee replacement surgery were treated with sciatic nerve combined with anesthesia after treatment to stabilize the vital signs of patients, and less dverse reactions, more suitable for knee replacement surgery anesthesia treatment.