对接受手术治疗的老年股骨骨折患者进行腰硬联合麻醉和术后硬膜外自控镇痛的效果评价

To evaluate the effect of combined lumbar and epidural anesthesia and postoperative epidural analgesia in the elderly patients with femoral fracture

目的:分析对接受手术治疗的老年股骨骨折患者进行腰硬联合麻醉和术后硬膜外自控镇痛的效果.方法:将2017年3月至2018年6月期间在绵竹市人民医院就诊的80例老年股骨骨折患者作为研究对象.将其均分为观察组与对照组.在对两组患者进行手术治疗期间,对对照组患者进行全身麻醉和术后静脉镇痛泵镇痛,对观察组患者进行腰硬联合麻醉和术后硬膜外自控镇痛.然后比较两组患者的麻醉镇痛效果、MMSE评分及术后并发症的发生率.结果:观察组患者麻醉镇痛的总有效率高于对照组患者,其术后并发症的发生率低于对照组患者,P<0.05.在术后6 h、12 h及24 h,观察组患者的MMSE评分均高于对照组患者,P<0.05.结论:对接受手术治疗的老年股骨骨折患者进行腰硬联合麻醉和术后硬膜外自控镇痛的效果显著,能够降低其术后并发症的发生率,改善其术后认知功能.

objective: to analyze the effect of combined lumbar and epidural anesthesia and postoperative epidural analgesia on elderly patients with femoral fracture who received surgical treatment. Methods: 80 elderly patients with femoral fractures who were treated in mianzhu people's hospital from March 2017 to June 2018 were selected as research objects. They were divided into observation group and control group. During the surgical treatment of patients in the two groups, general anesthesia and postoperative intravenous analgesia pump were applied to patients in the control group, combined lumbar and epidural anesthesia and postoperative epidural controlled analgesia were applied to patients in the observation group. Then, the analgesic effect, MMSE score and incidence of postoperative complications were compared between the two groups. Results: the total effective rate of anesthesia and analgesia in the observation group was higher than that in the control group, and the incidence of postoperative complications was lower than that in the control group (P < 0.05). At 6 h, 12 h and 24 h after surgery, MMSE scores of the observation group were all higher than those of the control group (P < 0.05). Conclusion: combined lumbago and epidural analgesia can significantly reduce the incidence of postoperative complications and improve the postoperative cognitive function of the elderly patients with femoral fracture.