比较椎管内麻醉和全身麻醉对高龄股骨粗隆间骨折患者术后恢复效果的影响

Effect of Intravertebral Anesthesia and General Anesthesia on postoperative recovery of elderly patients with Intertrochanteric fracture of femur

目的分析比较椎管内麻醉和全身麻醉对高龄股骨粗隆间骨折患者术后恢复效果。方法资料选取我院2016年12月-2017年12月收治的68例高龄股骨粗隆间骨折患者作为本次调查对象,将其分为观察组和对照组各34例,给予对照组全身麻醉,而给予观察组椎管内麻醉。分别比较两组患者术后恢复效果及并发症发生率。结果观察组患者术后并发症发生率为17. 65%,对照组为55. 88%,相比观察组明显低于对照组,差距显著(P <0. 05);观察组手术平均时间和术中出血量分别为(50. 5±6. 92) min和(95. 9±9. 92) ml,对照组分别为(51. 4±5. 78) min和(96. 1±10. 79) ml,相比无明显差距(P> 0. 05);但观察组术后下床时间和术后住院时间分别为(72. 8±10. 6) h和(8. 3±2. 98) d,对照组分别为(102. 8±11. 5) h和(13. 2±3. 01) d,相比观察组明显低于对照组(P <0. 05)。结论对于高龄股骨粗隆间骨折患者采用全麻或椎管全麻均可有效提高患者麻醉效果,但相比之下椎管内麻醉可有效缩短并发症发生率、术后下床时间及术后住院时间,提高临床治疗效果,值得临床大力推广。

Objective To analyze and compare the effect of intraspinal anesthesia and general anesthesia on postoperative recovery of elderly patients with intertrochanteric fracture of femur. Methods Sixty-eight elderly patients with intertrochanteric fracture of femur were selected from December 2016 to December 2017 in our hospital. They were divided into observation group（ n = 34） and control group（ n = 34）. The observation group was given intraspinal anesthesia. The effect of postoperative recovery and the incidence of complications were compared between the two groups. Results The incidence of postoperative complications was 17. 65 in the observation group and 55. 88 in the control group,which was significantly lower than that in the observation group（ P〈 0. 05）. The mean operative time and intraoperative bleeding volume were（ 50. 5 ± 6. 92） min and（ 95. 9 ± 9. 92） ml in the observation group,and（ 51. 4 ± 5. 78） min and（ 96. 1 ± 10. 79） ml in the control group,respectively. There was no significant difference between the two groups（ P〉 0. 05）. However,the time after operation and the hospitalization time of observation group were（ 72. 8 ± 10. 6） h and（ 8. 3 ± 2. 98） d,respectively,and the control group was（ 102. 8 ± 11. 5） h and（ 13. 2 ± 3. 01） d,respectively,which was significantly lower than that in the control group（ P〈 0. 05）. Conclusion General anesthesia or general spinal anesthesia can effectively improve the anesthetic effect of the elderly patients with intertrochanteric fracture of femur,but intraspinal anesthesia can effectively shorten the incidence of complications,the time of getting out of bed and the time of hospitalization after operation. To improve the effect of clinical treatment is worth popularizing.