老年人下肢骨折手术全身麻醉与腰硬联合麻醉临床效果比较研究

A Comparative Study on the Clinical Effect of General Anesthesia and Combined Lumbar and Epidural Anesthesia for Lower Extremity Fractures in the Elderly

目的分析在老年人下肢骨折手术中腰硬联合麻醉和全身麻醉的应用价值。方法选取2019年5月至2020年5月东明县人民医院骨科收治的120例老年下肢骨折手术患者为研究对象,按照麻醉方式分为研究组(60例,实施腰硬联合麻醉)和对照组(60例,实施全身麻醉)。分析两组的麻醉效果和并发症情况。结果研究组麻醉总有效率为96.67%,显著高于对照组80.00%,差异有统计学意义(χ^2=8.086,P<0.01)。麻醉前,两组血氧饱和度、心率、平均动脉压水平比较,差异无统计学意义(P>0.05);麻醉后,两组各指标水平均有所下降,且研究组氧饱和度、心率、平均动脉压水平分别为(98.13±0.22)%,(80.56±0.53)次/min,(76.02±0.28)mm Hg,均高于对照组(94.37±0.18)%、(73.56±0.64)次/min,(65.13±0.56)mm Hg,组间比较差异有统计学意义(t=88.659、53.278、110.006,P<0.01)。研究组不良反应发生率为8.33%,低于对照组21.67%,差异有统计学意义(χ^2=4.183,P<0.05)。结论在老年人下肢骨折手术中采用腰硬联合麻醉方式的麻醉效果优于全身麻醉方式,并发症发生率更低,安全性更高。

Objective To analyze the application value of combined lumbar epidural anesthesia and general anesthesia in the operation of lower extremity fracture in the elderly.Methods A total of 120 elderly patients with lower extremity fracture who were admitted to the Orthopedic Department of Dongming People's Hospital from May 2019 to May 2020 were selected as the study subjects,and divided into study group(60 cases,with combined spinal and epidural anesthesia)and control group(60 cases,with general anesthesia)according to the anesthesia method.The anesthesia effect and complications of the two groups were analyzed.Results The total effective rate of anesthesia was 96.67%in the study group,which was significantly higher than 80.00%in the control group,the difference was statistically significant(χ^2=8.086,P<0.01).Before anesthesia,there was no significant difference in blood oxygen saturation,heart rate and mean arterial pressure between the two groups(P>0.05);after anesthesia,the levels of each index in both groups decreased,and the levels of oxygen saturation,heart rate and mean arterial pressure in the study group were(98.13±0.22)%,(80.56±0.53)times/min,(76.02±0.28)mm Hg were higher than those in the control group(94.37±0.18)%,(73.56±0.64)times/min,(65.13±0.56)mm Hg,respectively.There was a significant difference between the two groups(t=88.659,53.278,110.006,P<0.01).The incidence of adverse reactions in the study group was 8.33%lower than 21.67%in the control group,the difference was statistically significant(χ^2=4.183,P<0.05).Conclusion Combined lumbar and epidural anesthesia is better than general anesthesia in the operation of lower extremity fracture in the elderly,with a lower incidence of complications and better safety.