老年下肢骨折患者手术连续硬膜外麻醉和腰麻对患者循环功能的影响

Effects of Continuous Epidural Anesthesia and Spinal Anesthesia on Circulatory Function in Elderly Patients with Lower Extremity Fractures

目的分析老年下肢骨折患者手术连续硬膜外麻醉和腰麻对患者循环功能的影响。方法方便选择该院自2014年1月—2016年12月收治的184例老年下肢骨折患者,将其随机分为2组,对照组和观察组,每组92例。所有患者均给予手术治疗,其中对照组患者麻醉方式为连续硬膜外麻醉,观察组给予腰麻,对两组患者麻醉前后血压及心率变化进行比较。结果所有患者的血压、心率均有一定的变化,对照组幅度较大,观察组相对稳定,相对比(P<0.05);观察组患者麻醉后SBP、DBP及HR数值分别为(119.29±14.34)mm Hg、(76.93±7.29)mm Hg及(76.29±7.98)次/min。观察组与对照组手术时间、达效时间及麻醉使用量对比,前者均明显少于后者(P<0.05);观察组患者手术时间、达效时间及麻醉使用量分别为(121.28±26.38)min、(4.78±2.01)min、(3.09±2.17)m L。结论对于行手术治疗的老年下肢骨折患者,无论是采用连续硬膜外麻醉方式还是腰麻方式,术后患者的血压、心率均有一定的波动,但连续腰麻方式变化幅度较小,更值得在临床使用。

Objective This paper tries to analyze the effect of continuous epidural anesthesia and spinal anesthesia on circulation function in elderly patients with lower extremity fractures. Methods A total of 184 patients with lower extremity fractures from January 2014 to December 2016 were convenient selected and were randomly divided into two groups： the control group and the observation group, with 92 cases in each group. All patients were given surgical treatment, in which the control group of patients with anesthesia for continuous epidural anesthesia, the observation group was given spinal anesthesia, the anesthesia blood pressure and heart rate changes of two groups of patients before and after were compared. Results The blood pressure and heart rate of all the patients were changed, and the degree was larger in the control group, the observation group was relatively stable（P 0.05）;The levels of SBP, DBP and HR in the observation group were（119.29 ±14.34） mm Hg,（76.93±7.29）mm Hg and（76.29±7.98）times/min respectively. The time of onset and the dosage of the observation group were significantly lower than those of the control group（P〈0.05）; The duration of operation, duration of effect and anesthesia in the observation group were（121.28±26.38）min,（4.78±2.01）min,（3.09±2.17）m L. Conclusion For elderly patients with lower extremity fractures undergoing surgical treatment, whether using continuous epidural anesthesia or spinal anesthesia, postoperative blood pressure and heart rate have a certain degree of volatility, but the change degree of the continuous epidural anesthesia is lower, so it is worth clinical use.