超声显像辅助老年患者椎管内麻醉的效果观察

Effect Observation of intraspinal anesthesia assisted by ultrasonic imaging in elderly patients

目的探讨超声显像辅助老年患者椎管内麻醉的应用效果。方法 40例采用椎管内麻醉实施下肢手术的老年患者,随机分为传统解剖定位组和超声辅助定位组,每组20例。比较两组患者穿刺过程中的定位时间、穿刺时间、操作时间、穿刺总耗时和平均穿刺次数、调整穿刺针方向次数、硬膜外穿刺针深度等。结果超声辅助定位组患者定位时间(2.82±0.26)min穿刺时间(2.56±1.22)min、操作时间(6.98±2.05)min及穿刺总耗时(11.14±3.72)min明显短于传统解剖定位组的(0.46±0.08)、(4.37±2.03)、(8.95±3.26)、(13.98±3.59)min,差异有统计学意义(P<0.05)。超声辅助定位组患者平均穿刺次数(1.32±0.25)次、调整穿刺针方向次数(3.31±0.87)次少于传统解剖定位组的(2.21±0.41)、(5.48±1.03)次,一次穿刺成功率65.0%明显高于传统解剖定位组的30.0%,差异有统计学意义(P<0.05)。结论超声显像在辅助老年患者椎管内麻醉中具有明显的临床优势,值得临床推广应用。

Objective To explore the application effect of intraspinal anesthesia assisted by ultrasonic imaging in elderly patients.Methods A total of 40 elderly patients with intraspinal anesthesia for lower limb surgery were randomly divided into traditional anatomical location group and ultrasonic aided positioning group,20 cases in each group.The location time,puncture time,operation time,total time of puncture,average puncture times,number of puncture needle direction and depth of epidural puncture needle in puncture process were compared between two groups.Results The location time,location time,puncture time,operation time and total time of puncture in the ultrasonic aided positioning group were(2.82±0.26)min,(2.56±1.22)min,(6.98±2.05)min and(11.14±3.72)min respectively,which were significantly shorter than(0.46±0.08)min,(4.37±2.03)min,(8.95±3.26)min and(13.98±3.59)min in the traditional anatomical location group,the differences were statistically significant(P<0.05).The average puncture times and number of puncture needle direction in the ultrasonic aided positioning group were(1.32±0.25)times and(3.31±0.87)times respectively,which were significantly less than(2.21±0.41)times and(5.48±1.03)times in the traditional anatomical location group,the one-time success rate of puncture in ultrasonic aided positioning group was 65.0%,which was significantly higher than 30.0%in the traditional anatomical location group,the differences were statistically significant(P<0.05).Conclusion Ultrasonic imaging has obvious clinical advantages in assisting elderly patients with intraspinal anesthesia,and is worthy of clinical application.