老年人下肢骨折手术采用全身麻醉与腰硬联合麻醉临床效果对比分析

Comparative Analysis of Clinical Effects of General Anesthesia and Combined Spinal and Epidural Anesthesia in Elderly Patients with Lower Extremity Fracture

目的探讨老年人下肢骨折手术采用全身麻醉与腰硬联合麻醉临床效果。方法方便抽取2017年2—10月老年人下肢骨折手术患者90例,根据患者治疗意愿分组。对照组进行全身麻醉,观察组进行腰硬联合麻醉。比较两组老年人下肢骨折手术的麻醉效果;术后清醒的时间;麻醉前后患者平均动脉压水平、心率以及血氧饱和度水平;低血压、低心率等并发症率。结果观察组老年人下肢骨折手术的麻醉效果44例(97.78%)高于对照组34例(75.55%)(χ~2=9.615,P<0.05);观察组术后清醒的时间(4.02±1.12)min优于对照组(7.14±3.24)min,(t=8.256,P<0.05);麻醉后观察组平均动脉压水平、心率以及血氧饱和度水平(78.23±0.32)mmHg、(81.21±0.51)次/min、(98.21±0.51)%优于对照组(67.29±0.69)mmHg、(73.92±0.13)次/min、(95.92±0.13)%(t=8.211,7.921,6.922,P<0.05)。观察组低血压、低心率等并发症率4例(8.89%)低于对照组11例(24.44%)(χ~2=3.9200,P<0.05)。结论老年人下肢骨折手术采用全身麻醉与腰硬联合麻醉临床效果比较,后者的麻醉效果更好,可更好缩短清醒时间,减少并发症。

Objective To investigate the clinical effects of general anesthesia and combined spinal and epidural anesthesia in elderly patients with lower extremity fractures. Methods A total of 90 patients with lower extremity fractures from February 2017 to October 2017 were convenient enrolled according to the patient’s willingness. The control group underwent general anesthesia and the observation group underwent combined spinal and epidural anesthesia. The anesthetic effect of lower limb fracture surgery in the two groups was compared as well as the time of awake after surgery;the mean arterial pressure level, heart rate and oxygen saturation level before and after anesthesia;the complication rate of hypotension and low heart rate. Results The anesthetic effect of the lower extremity fracture in the observation group was 44 cases(97.78%) higher than that of the control group 34 cases(75.55%),(χ^2=9.615, P<0.05). The awake time of the observation group was(4.02±1.12)min better than the control group(7.14±3.24)min(t=8.256, P<0.05);the mean arterial pressure level, heart rate and oxygen saturation level of the observation group after anesthesia were(78.23±0.32)mmHg,(81.21±0.51)times/min,(98.21±0.51)% better than the control group(67.29 ±0.69)mmHg(73.92 ±0.13)times/min,(95.92 ±0.13)%(t =8.211, 7.921,6.922,P<0.05). The complication rate of hypotension and low heart rate in the observation group was 4 cases(8.89%) lower than that in the control group 11 cases(24.44%)(χ^2=3.920 0, P<0.05). Conclusion The clinical effect of general anesthesia combined with spinal and epidural anesthesia was compared in the elderly with lower extremity fracture surgery. The latter has a better anesthetic effect, which can shorten the waking time and reduce complications.