高危骨科手术患者通过腰硬联合麻醉结合容量治疗对心肺功能影响

Effect of Volume Therapy Combined with Lumbar and Epidural Anesthesia on Cardiopulmonary Function in High-risk Orthopedic Surgery Patients

目的:研究高危骨科手术患者通过腰硬联合麻醉结合容量治疗对心肺功能影响和显效时间的影响价值。方法:选取2017年11月~2018年11月期间某院接收的高危骨科手术患者68例为研究对象,采用随机数字法分为硬膜外麻醉组和联合麻醉组各34例,硬膜外麻醉组患者采用硬膜外麻醉,联合麻醉组采用腰硬联合麻醉结合容量治疗,研究两组麻醉阻滞显效时间,麻醉阻滞完善时间,麻醉前后心率、收缩压(SBP)、舒张压(DBP)。结果:联合麻醉组麻醉阻滞显效时间、麻醉阻滞完善时间明显低于硬膜外麻醉组(P<0.05);麻醉后,硬膜外麻醉组患者心率水平值明显高于麻醉前(P<0.05),收缩压和舒张压血压水平值明显低于麻醉前(P<0.05);麻醉后,联合麻醉组的心率、舒张压和收缩压水平值相比麻醉前,无明显差异性(P>0.05)。结论:高危骨科手术患者通过腰硬联合麻醉结合容量治疗对心肺功能影响和显效时间的影响价值显著,可在临床上推广应用。

Objective:To study the effect of lumbar and epidural anesthesia combined with volume therapy on cardiopulmonary function and duration of obvious effect in high-risk orthopedic surgery patients.Methods:68 patients with high-risk orthopaedic surgery treated in a hospital from November 2017 to November 2018 were selected as the research object and divided into epidural anesthesia group(34 cases)and combined anesthesia group(34 cases)by using random numbers.The epidural anesthesia group was given epidural anesthesia,and the combined anesthesia group was given lumbar and epidural anesthesia combined with volume therapy,then the effective time of anesthesia block,the perfect time of anesthesia block,heart rate,systolic blood pressure(SBP)and diastolic blood pressure(DBP)before and after the treatment in the two groups were compared.Results:The time of anesthesia block and the perfect time of anesthesia block in the combined anesthesia group were significantly lower than those in the epidural anesthesia group(P<0.05).The heart rate level of epidural anesthesia group was significantly higher than that before anesthesia(P<0.05),and the systolic blood pressure and diastolic blood pressure were significantly lower than those before anesthesia(P<0.05).After anesthesia,there was no significant difference in heart rate,diastolic blood pressure and systolic blood pressure in the combined anesthesia group compared with before the anesthesia(P>0.05).Conclusion:Lumbar and epidural anesthesia combined with volume therapy for high risk orthopedic surgery patients has significant effects on cardiopulmonary function and apparent effect time,which can be widely used in clinical practice.