老年下肢骨折手术中腰麻-硬膜外联合麻醉的应用分析

Application of combined spinal-epidural anesthesia in the operation of lower limb fracture in the elderly

目的探讨老年下肢骨折手术中腰麻-硬膜外联合麻醉的应用效果.方法在赣州市南康区中医院2015年1月至2018年12月期间诊治的老年下肢骨折手术患者中选取80例作研究对象,术中均实行麻醉处理,但麻醉方式不同:将实行连续硬膜外麻醉者设为对照组(n=40),将实行腰麻-硬膜外联合麻醉者设为研究组(n=40),就两组患者麻醉阻滞起效时间、麻醉阻滞完善时间、术中麻醉效果优良率以及术后神经系统并发症情况进行统计学分析.结果研究组麻醉阻滞起效时间与阻滞完善时间均短于对照组(t=16.464、19.799,P=0.000);研究组患者术中麻醉优良率95.0%高于对照组的80.0%(Χ^22=4.114,P=0.043);两组患者术后均无神经系统并发症.结论老年下肢骨折手术中腰麻-硬膜外联合麻醉的应用效果更佳,具有起效快、阻滞完善等优越性,且安全性高,尤其适宜老年人应用,值得借鉴.

Objective To investigate the effect of combined spinal and epidural anesthesia in the operation of lower limb fracture in the elderly. Methods Eighty elderly patients with lower extremity fracture treated in Nankang District Hospital of Ganzhou City from January 2015 to December 2018 were selected as the study subjects. Anesthesia was performed during the operation, but the anesthesia methods were different: the patients who underwent continuous epidural anesthesia were set as the control group (n=40), and the patients who underwent combined spinal and epidural anesthesia were set as the study group (n=40). Anesthesia was blocked in both groups. The onset time of anesthesia, the perfect time of anesthesia, the excellent and good rate of anesthesia effect during operation and the complications of nervous system after operation were statistically analyzed. Results The onset time and perfect time of anesthesia block in the study group were shorter than those in the control group (t=16.464, 19.799, P= 0.000). The excellent rate of anesthesia in the study group was 95.0% higher than 80.0% in the control group (Χ^2=4.114, P=0.043). There were no neurological complications in both groups after operation. Conclusion The combined spinal-epidural anesthesia is more effective in the operation of lower limb fracture in the elderly, which has the advantages of quick onset, perfect block and high safety. It is especially suitable for the elderly.