对接受内固定手术的老年股骨颈骨折患者进行喉罩通气全麻的效果探讨

To study the effect of laryngeal mask airway ventilation and general anesthesia in elderly patients with femoral neck fracture who received internal fixation

目的 :探讨对接受内固定手术的老年股骨颈骨折患者进行喉罩通气全麻的效果。方法 :随机选择简阳市中医医院收治的需择期进行内固定手术的78例老年股骨颈骨折患者作为研究对象。采用随机信封法将其分为对照组(n=39)和喉罩组(n=39)。在手术期间,对对照组患者进行腰硬联合麻醉,对喉罩组患者进行喉罩通气全麻。然后对比两组患者麻醉的效果、MAP、HR、SPO_2、不良反应的发生率、麻醉起效的时间和VAS评分。结果 :喉罩组患者麻醉的总有效率高于对照组患者(P <0.05)。在麻醉后5min,喉罩组患者的MAP、HR均低于对照组患者,其SPO_2高于对照组患者(P <0.05)。在固定骨折端时,喉罩组患者的MAP、HR、SPO_2均高于对照组患者(P <0.05)。接受麻醉后,喉罩组患者麻醉起效的时间短于对照组患者,其VAS评分低于对照组患者(P <0.05)。在接受麻醉期间,喉罩组患者不良反应的发生率低于对照组患者(P <0.05)。结论 :对接受内固定手术的老年股骨颈骨折患者进行喉罩通气全麻的效果较好。

objective： to explore the effect of general laryngeal mask airway ventilation on elderly patients with femoral neck fracture undergoing internal fixation. Methods： 78 senile patients with femoral neck fracture who needed internal fixation surgery were selected as subjects. Random envelope method was used to divide them into control group （n=39） and laryngeal mask airway （n =39）. During the operation, patients in the control group were treated with combined lumbar anaesthesia, and patients in the laryngeal mask airway were treated with general laryngeal mask airway. Then, the anesthetic effect, MAP, HR, SPO2, incidence of adverse reactions, onset time and VAS score of the two groups were compared. Results： the total effective rate of anesthesia in the laryngeal mask airway group was higher than that in the control group （P 〈 0.05）. 5 rain after anesthesia, MAP and HR of patients in the laryngeal mask airway group were lower than those in the control group, and SPO2 was higher than those in the control group （P 〈 0.05）. MAP, HR and SPO2 were all higher in the laryngeal mask airway than in the control group （P 〈 0.05）. After the administration of anesthesia, the onset time of anesthesia in the laryngeal mask airway group was shorter than that of the control group, and the VAS score was lower than that of the control group （P 〈 0.05）. The incidence of adverse reactions in the laryngeal mask airway group was lower than that in the control group （P 〈 0.05）. Conclusion： it is effective to perform laryngeal mask airway ventilation and general anesthesia for elderly patients with femoral neck fracture undergoing internal fixation.