腰硬联合麻醉对骨科患者应激反应的影响

Effect of Combined Spinal and Epidural Anesthesia on Stress Response of Orthopedic Patients

目的探讨腰硬联合麻醉对骨科手术患者术中应激反应的影响。方法选择收治骨科手术患者120例,所有患者均于2018年1月—2019年6月在本院接受治疗,按照随机数字表法分为试验组(n=60)和常规组(n=60)。常规组实施全身麻醉,试验组实施腰硬联合麻醉,观察两组患者应激指标、不良反应。结果试验组术后1小时肾素(2.1±0.4)ng/L、肾上腺素(78.6±10.2)μg/L、去甲肾上腺素(90.3±11.5)ng/L、血管紧张素(22.6±4.6)μg/L,均低于常规组的(4.2±0.6)ng/L、(127.3±17.4)μg/L、(177.4±21.1)ng/L、(60.6±8.1)μg/L,差异有统计学意义(t=13.54,P=0.00;t=10.35,P=0.00;t=12.87,P=0.00;t=20.34,P=0.00)。试验组并发症发生率5.0%,低于常规组的16.7%,差异有统计学意义(χ^2=7.57,P=0.00)。结论在骨科手术患者中实施腰硬联合麻醉能够明显减轻患者应激反应,且不良反应较少。

Objective To explore the effect of hard combined anesthesia on intraoperative stress response in patients undergoing orthopedic surgery.Methods 120 cases of orthopedic surgery patients were selected,all of whom received treatment in the hospital from January 2018 to June 2019,and were divided into experimental group and conventional group according to the random number table method.General anesthesi a was performed i n the routine group and combined lumbar and epidural anesthesia in the experimental group.Hemodynamic indexes,stress indexes and adverse reactions were observed in the two groups.Results Renin(2.1±0.4)ng/L,epinephrine(78.6±10.2)ug/L,norepinephrine(90.3±11.5)ng/L,angiotensin(22.6±4.6)ug/L,were significantly lower in the experimental group than in the conventional group(4.2±0.6)ng/L,(127.3±17.4)μg/L,(177.4±21.1)ng/L,(60.6±8.1)μg/L.The difference is statistically significant(t=13.54,P=0.00;t=10.35,P=0.00;t=12.87,P=0.00;t=20.34,P=0.00).The complication rate of the experimental group was 5.0%,which was significantly lower than that of the conventional group 16.7%,The difference is statistically significant(χ^2=7.57,P=0.00).Conclusion Combined lumbar and epidural anesthesia in patients undergoing orthopedic surgery can significantly reduce the stress response of patients,improve hemodynamic indexes,and have fewer adverse reactions.