比较喉罩通气全麻与腰硬联合麻醉在老年股骨颈骨折内固定术麻醉中的效果

Comparison of Effects of Combined Laryngeal Mask Ventilation Anesthesia and Lumbar-sparing Anesthesia on Senile Femoral Neck Fractures with Internal Fixation

目的研讨老年股骨颈骨折内固定术患者接受喉罩通气全麻与腰硬联合麻醉的临床价值。方法本实验抽选我院行股骨颈骨折内固定术处理的50例老年患者作为观察对象,入选患者按随机数表法划分为两组,Ⅰ组(n=25)接受腰硬联合麻醉,Ⅱ组(n=25)接受喉罩通气全麻,对比评估两组的麻醉效果,包括不同操作阶段的血流动力学指标、疼痛程度及麻醉安全性。结果在T1~T3操作阶段,Ⅱ组相比Ⅰ组在上述血流动力学指标上均更平稳,比较有统计学意义(P<0.05)。麻醉后6h,Ⅰ、Ⅱ组的VAS评估值相比,Ⅰ组显著降低,比较有统计学意义(P<0.05)。两组在实验期间均有出现副反应,但Ⅱ组相比Ⅰ组在总发生率上明显降低,比较有统计学意义(P<0.05)。结论对老年股骨颈骨折内固定术患者实施喉罩通气麻醉是一种可行的麻醉方法,能够取得较腰硬联合麻醉更平稳的血流动力学,并且疼痛更轻、副反应更少,值得推荐。

Objective To investigate the clinical value of joint anesthesia with laryngeal mask ventilation combined with lumbar dialysis in elderly patients with internal fixation of femoral neck fractures.Methods In this study,50 elderly patients treated with internal fixation of femoral neck fractures in our hospital were selected as observation objects.The patients were selected into two groups according to the random number table method.Group Ⅰ（n=25） received combined spinal and epidural anesthesia.Group Ⅱ（n=25） underwent laryngeal mask ventilation and general anesthesia.The anesthetic effects of the two groups were compared and evaluated,including hemodynamic parameters,pain level,and anesthetic safety at different operation stages.Results During the T1~T3 operation stage,the hemodynamic parameters were more stable in group Ⅱ than in group Ⅰ（P0.05）.At 6 h after anesthesia,the VAS values of group Ⅰ and Ⅱ were significantly lower than those of group Ⅰ,which was statistically significant（P0.05）.Both groups had adverse reactions during the experimental period,but the total incidence of group Ⅱ was significantly lower than that of group Ⅰ,with statistical significance（P0.05）.Conclusion Laryngeal mask ventilation anesthesia for elderly patients with internal fixation of femoral neck fractures is a feasible anesthetic method.It can achieve more stable hemodynamics than lumbar and anesthesia,and has less pain and fewer side effects.It is worth recommend.