硬膜外麻醉和静脉全麻两种方式对糖尿病患者下肢骨折手术的麻醉效果观察

Effect of Two Kinds of Epidural Anesthesia and Intravenous Anesthesia on Lower Limb Fracture in Patients with Diabetes

目的观察硬膜外麻醉和静脉全麻两种方式对糖尿病患者下肢骨折手术的麻醉效果。方法将2010年1月—2016年6月期间该院收治行下肢骨折手术的189例糖尿病患者,随机分成观察组(硬膜外麻醉组)95例和对照组(静脉全麻组)94例。对照组采用全身静脉麻醉,观察组采用硬膜外阻滞麻醉。所有患者给予持续心电监护,记录不同手术时段的血压、心率及血糖的变化。结果两组患者均顺利完成手术,无意外情况出现,麻醉手术后患者心率、血压及血糖均有所提高,但观察组心率、血压及血糖水平上升幅度低于对照组,P<0.05;观察组手术时间明显低于对照组,P<0.05。结论硬膜外麻醉较静脉全麻的方案更有助于维持糖尿病患者手术期间血糖和生命体征指标的稳定,是糖尿病患者实施下肢骨折手术治疗时较为合适的麻醉方式。

Objective To observe the effect of two kinds of epidural anesthesia and intravenous anesthesia on lower limb fracture surgery in patients with diabetes. Methods Dring January 2010 to June 2016, 189 cases of diabetic patients with lower limb fracture surgery were randomly divided into observation group (epidural anesthesia group) 95 cases and control group (intravenous anesthesia group) in 01 cases, 06 cases and control group (intravenous general anesthesia group), 94 cases in the control group and cases in the control group. In the control group, the total intravenous anesthesia was used, andthe observation group was anesthetized with epidural anesthesia. All patients were given continuous ECG monitoring torecord the changes of blood pressure, heart rate and blood glucose during different periods of operation. Results Two patients were successfully completed the operation, no unexpected, anesthesia, blood pressure and blood sugar of patients were improved after surgery, heart rate, blood pressure and heart rate, but the observation group blood glucose level increased significantly lower than the control group, P < 0.05; The operation time of the observation group was significantly lower than the control group, P < 0.05. Conclusion Epidural anesthesia with intravenous anesthesia for more help to maintain blood glucose during surgery in patients with diabetes and vital signs were stable, the surgical treatment of lower extremity fractures in patients with diabetes to implement appropriate anesthesia.