不同麻醉方法对老年全髋关节置换术患者术后深静脉血栓发生率的影响分析

Analysis of Effect of Different Anesthesia Methods on Incidence of Deep Venous Thrombosis in Elderly Patients Undergoing Total Hip Replacement

目的分析不同麻醉方法对老年全髋关节置换术患者术后深静脉血栓(DVT)发生率的影响。方法选取2018年8月至2019年7月福建医科大学附属协和医院收治的76例全髋关节置换术治疗的老年患者,随机分为对照组、试验组,各38例。对照组给予全身麻醉,试验组给予硬膜外麻醉,比较血液流变学指标、凝血指标和DVT发生率。结果试验组术后1 d全血低切黏度、全血高切黏度、纤维蛋白原低于对照组,试验组凝血酶时间、凝血酶原时间高于对照组,血小板计数低于对照组(P<0.05);试验组DVT发生率为2.63%,低于对照组15.79%(P<0.05)。结论全髋关节置换术中应用硬膜外麻醉能够预防DVT发生,且对患者血液流变和凝血情况影响较小,适合于老年患者。

Objective To analyze the effect of different anesthesia methods on the incidence of postoperative deep venous thrombosis(DVT)in elderly patients undergoing total hip arthroplasty.Methods From August 2018 to July 2019,76 elderly patients who underwent total hip arthroplasty in Union Hospital affiliated to Fujian Medical University were selected.The patients were randomLy assigned to the control group and the experimental group,38 cases each.The control group were given general anesthesia,the experimental group were given epidural anesthesia,blood rheology,coagulation parameters and DVT incidence are compared.Results In the experimental group,the low-cut viscosity,whole blood high-viscosity and fibrinogen were lower in the experimental group than in the control group.The PT and TT in the experimental group were higher than those in the control group,and the platelet was lower than the control group(P<0.05).The incidence of DVT in the test group was 2.63%,which was lower than that in the control group 15.79%(P<0.05).Conclusion Epidural anesthesia in total hip arthroplasty can prevent DVT,and it has little effect on blood rheology and coagulation,especially for elderly patients.