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三种不同麻醉方法对老年膝关节置换术和下肢骨折内固定术患者麻醉效果的比较 被引量:12

Effects of three different anesthesia methods on hemodynamics in elderly patients undergoing total knee arthroplasty and internal fixation of lower limb fractures
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摘要 目的:研究三种麻醉方法对老年膝关节置换术和下肢骨折内固定术患者血流动力学的影响。方法:选择行膝关节置换术和下肢骨折内固定术患者180例,随机分为A、B、C三组各60例,分别给予全身麻醉、椎管内麻醉与椎管内麻醉联合股神经阻滞麻醉,比较三组的临床麻醉效果,分别于T0(术中)、T1(手术结束)、T2(术后24 h)检测三组患者的脉搏血氧饱和度、平均动脉压和心率。结果:C组的麻醉有效率为96.6%(58/60),高于A组以及B组(P<0.05);在T 03个组的脉搏血氧饱和度、平均动脉压和心率相比差异无统计学意义(P>0.05),在T 1、T 2 3个组的脉搏血氧饱和度、平均动脉压和心率均发生不同程度的改变,但C组的改变幅度低于A组、B组(P<0.05)。结论:椎管内麻醉联合股神经阻滞麻醉对老年膝关节置换术和下肢骨折内固定术患者的临床麻醉效果优于全身麻醉、椎管内麻醉,可减轻对患者血流动力学的影响。 Objective:To study the effects of three different anesthesia methods on hemodynamics in elderly patients undergoing total knee arthroplasty and internal fixation of lower limb fractures.Methods:180 patients who were performed knee arthroplasty and internal fixation of lower limb fractures were chosen and randomly divided into Group A,Group B and Group C,60 cases in every group.They were treated with general anesthesia,intraspinal anesthesia and spinal anesthesia combined with femoral nerve block anesthesia respectively,with the anesthetic effects compared.The oxygen saturation,the mean arterial pressure,and the heart rate of the three groups at T0(during the operation),T1(after the operation),T2(24 hours after the operation) were examined.Results:The effective rate of group C was 96.67 %(58/60),which was significantly higher than that of group A and group B(P〈0.05).At T0,there was no significant difference in the oxygen saturation,the mean arterial pressure,and the heart rate among the three groups(P〉0.05).At T1 and T2,the oxygen saturation,the mean arterial pressure,and the heart rate of the three groups changed in varying degrees,but the range of change in the Group C was significantly narrower than that in the Group A and Group B(P〈0.05).Conclusion:Spinal anesthesia combined with femoral nerve block anesthesia is superior to general anesthesia and intraspinal anesthesia in elderly patients undergoing total knee arthroplasty and internal fixation of lower limb fractures and can effectively reduce hemodynamics in patients.
作者 雷家秀
出处 《包头医学院学报》 CAS 2018年第1期61-62,共2页 Journal of Baotou Medical College
关键词 膝关节置换术 下肢骨折内固定术 血流动力学 Total knee arthroplasty Internal fixation of lower limb fractures Hemodynamics
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