老年全髋关节置换术椎管内麻醉的临床分析

Clinical Analysis of Spinal Anesthesia in Elderly Patients Undergoing Total Hip Replacement

目的分析老年全髋关节置换术行椎管内麻醉的临床效果。方法选取2018年7月至2020年7月本院30例行老年全髋关节置换术患者,按随机平均分组原则给予两组患者不同的麻醉手术,观察组行椎管内麻醉,对照组行全身麻醉,观察两组的麻醉效果、认知功能、手术指标、不良事件发生。结果经过麻醉后,两组的手术用时、术中出血量无统计学意义(P>0.05);而观察组的术后麻醉留观时间、住院时间明显低于对照组,差异有统计学意义(P<0.05)。观察组认知功能评分(术后1h、3h、6h、12h)均明显高于对照组(P<0.05)。观察组的切口感染、假体松动不良事件与对照组差异较小(P>0.05);其他不良事件(下肢深静脉血栓、低血压)发生率均明显低于对照组(P<0.05)。观察组的麻醉有效率明显更高(P<0.05)。结论椎管内麻醉应用于老年全髋关节置换术中效果显著,可以缩短术后麻醉留观时间,加快患者的认知功能恢复,减少下肢静脉血栓等不良事件,值得临床推广。

Objective To analyze the clinical effect of spinal anesthesia in elderly patients with total hip replacement.Methods Thirty elderly patients with total hip arthroplasty in our hospital from July 2018 to July 2020 were selected and given different anesthesia operations according to the principle of random average grouping.The observation group was given spinal anesthesia,while the control group was given general anesthesia.The anesthesia effect,cognitive function,operation indexes and adverse events of the two groups were observed.Results After anesthesia,the operation time and intraoperative blood loss of the two groups were not statistically significant (P>0.05),while the postoperative anesthesia observation time and hospitalization time of the observation group were significantly lower than those of the control group (P<0.05).The scores of cognitive function in the observation group (1 h,3 h,6 h,12 h after operation) were significantly higher than those in the control group (P<0.05).The difference of incision infection and prosthesis loosening adverse events between the observation group and the control group was small (P>0.05).The incidence of other adverse events (lower extremity deep vein thrombosis,hypotension) in the observation group was significantly lower than that in the control group (P<0.05).The effective rate of anesthesia in the observation group was significantly higher (P<0.05).Conclusion Spinal anesthesia in elderly patients with total hip arthroplasty has a significant effect,can shorten the postoperative anesthesia observation time,accelerate the recovery of cognitive function,reduce the adverse events such as lower extremity venous thrombosis,which is worthy of clinical promotion.