腰硬联合麻醉在下肢骨折手术对WBC、CRP、ALB、PCT的影响

Effect of Combined Spinal and Epidural Anesthesia on WBC, CRP, ALB and PCT in Lower Extremity Fracture Surgery

目的:通过腰硬联合麻醉在下肢骨折手术中对白细胞(white blood cell,WBC)、白蛋白(albumin,ALB)、C-反应蛋白(C-reactive protein,CRP)、降钙素原(procalcitonin,PCT)的影响分析,探讨腰硬联合麻醉在下肢骨折手术中的应用价值。方法:选取本院2018年12月到2019年10月择期髋部骨折手术的老年患者88例,按不同麻醉方法分为观察组(n=48)与对照组(n=40);对照组为全身麻醉,观察组为腰硬联合麻醉,以WBC、CRP、ALB、PCT为观察指标,结合术后疼痛及术中麻醉效果对腰硬联合麻醉在下肢骨折手术中的应用进行分析评价。结果:观察组术后4 h、24 h、48 h的静息疼痛评分都显著低于对照组(P<0.05)。观察组的感觉阻滞时间、阻滞完善时间、痛觉恢复时间都显著短于对照组(P<0.05)。观察组术后1 d、7 d的WBC、ALB值与对照组对比差异无统计学意义(P>0.05),观察组术后1 d、7 d的血清CRP、PCT含量都显著低于对照组(P<0.05)。结论:腰硬联合麻醉在下肢骨折手术中的应用并不会影响WBC、ALB的表达,但可减轻CRP、PCT的血浓度,能更好的提高麻醉效果,发挥镇痛作用,延长术后无痛时间,从而促进患者的康复。

Objective: Through the analysis of the effect of combined spinal and epidural anesthesia on white blood cell(WBC),albumin(ALB), C-reactive protein(CRP), procalcitonin(PCT) in lower extremity fracture surgery, to explore the application value of combined spinal and epidural anesthesia in the operation of lower limb fracture. Methods: From December 2018 to October 2019, 88 elderly patients with hip fracture operation were selected and divided into observation group(n=48) and control group(n=40) according to different anesthesia methods. The control group received general anesthesia, while the observation group received combined spinal and epidural anesthesia. WBC, CRP, ALB and PCT were used as observation indicators, combined with postoperative pain and intraoperative anesthesia to the response of combined spinal and epidural anesthesia in lower limb fracture operation. Results: The resting pain scores of the observation group at 4 h, 24 h and 48 h after operation in the observation group were significantly lower than those of the control group(P<0.05). The sensory block time, block time and pain recovery time of the observation group were significantly lower than those of the control group(P<0.05). There were no significant differences in WBC and ALB compared between the observation group and the control group at 1 and 7 d after operation(P>0.05). The serum CRP and PCT levels in the observation group were significantly lower than those in the control group at 1 and 7 d after operation(P<0.05). Conclusion: The application of combined spinal-epidural anesthesia anesthesia in lower limb fracture surgery does not affect the expression of WBC and ALB, but can reduce the blood concentration of CRP and PCT, it can improve the anesthetic effect, play a analgesic role, prolong the postoperative painless time, so that promoting the recovery of patients.