腰硬联合麻醉对老年骨科手术患者术中安全性和预后质量分析及呼吸系统感染的临床特点观察

Analysis of intraoperative safety and prognosis quality and clinical characteristics of respiratory infection in elderly patients undergoing orthopedic surgery

目的探讨腰硬联合麻醉在老年骨科手术患者术中的应用及对肺部感染发生率的影响。方法选取2016年7月—2017年5月就诊于北京积水潭医院的老年股骨颈骨折患者62例作为研究对象,随机分为实验组和对照组,各31例。所有患者均行股骨颈骨折手术治疗,对照组采用全身麻醉,实验组采用腰硬联合麻醉,比较不同麻醉方式对患者预后及术后肺部感染情况的影响。结果麻醉期间实验组患者低血压、心动过缓、缺氧等不良反应发生率明显低于对照组(P<0.05),术后肺部感染发生率明显低于对照组,实验组发生术后躁动的患者比例也明显低于对照组(P<0.05)。结论腰硬联合麻醉应用于老年骨科手术患者能有效降低术后肺部感染及其他并发症发生率,安全性高,值得推广。

Objective To investigate the application of combined spinal and epidural anesthesia and general anesthesia in the treatment of femoral neck fractures in elderly patients and the impact on the incidence of pulmonary infection.Methods A total of 62 patients with femoral neck fractures who were treated in Beijing Jishuitan Hospital from July 2016 to May 2017 were enrolled.The patients were randomly divided into an experimental group(31 cases)and a control group(31 cases).All patients underwent surgical treatment of femoral neck fracture.The control group received general anesthesia.The experimental group received combined spinal and epidural anesthesia.The effects of different anesthesia methods on prognosis and pulmonary infection were compared.Results During the anesthesia,the incidence of adverse reactions such as hypotension,bradycardia,and hypoxia was significantly lower in the experimental group than in the control group(P<0.05).The incidence of postoperative pulmonary infection in the experimental group was significantly lower than that in the control group(P<0.05).The proportion of patients with postoperative agitation in the experimental group was also significantly lower than that of the control group(P<0.05).Conclusions Combined spinal and epidural anesthesia can effectively reduce the incidence of postoperative pulmonary infection and other complications in the elderly orthopedic surgery patients.It is safe and worthy of promotion.