气管插管与喉罩麻醉在四肢骨折内固定术患者中的应用效果

Application Effect of Endotracheal Intubation and Laryngeal Mask Anesthesia in Patients Undergoing Internal Fixation of Limb Fractures

目的分析气管插管与喉罩麻醉对四肢骨折内固定术患者应用效果。方法选取2018年9月至2021年4月郑州新华医院骨科收治的121例四肢骨折患者,按照麻醉方法分为观察组(61例,接受喉罩麻醉)和对照组(60例,接受气管插管麻醉)。比较两组患者术后24 h的应激指标[超氧化物歧化酶(SOD)、皮质醇(Cor)、谷胱甘肽(GSH)]水平以及并发症发生率、术中出血量、骨折愈合时间、腕关节功能。结果术后24 h,两组SOD、GSH水平高于术前,Cor水平低于术前(P<0.05),且观察组SOD、GSH水平高于对照组,Cor水平低于对照组(P<0.05)。观察组术中出血量少于对照组,骨折愈合时间短于对照组(P<0.05)。术后3个月,观察组腕关节功能评分低于对照组(P<0.05)。观察组术后并发症发生率低于对照组(P<0.05)。结论喉罩麻醉应用于四肢骨折内固定术患者可减轻患者应激反应,减少术中出血量,缩短骨折愈合时间,改善腕关节功能,降低并发症发生率,值得临床推广应用。

Objective To explore the application effect of endotracheal intubation and laryngeal mask anesthesia in patients undergoing internal fixation of limb fractures.Methods One hundred and twenty-one patients with limb fractures treated in the Department of Orthopedics of Zhengzhou Xinhua Hospital from September 2018 to April 2021 were selected and divided into observation group(61 cases,accepted laryngeal mask anesthesia)and control group(60 cases,accepted endotracheal intubation anesthesia).The 24-hour stress indexes[superoxide dismutase(SOD),cortisol(Cor),glutathione(GSH)]levels,the incidence of complications,intraoperative bleeding volume,fracture healing time and wrist joint function were compared between the two groups.Results Twenty-four hours after operation,the levels of SOD and GSH in the two groups were higher than those before operation,and the levels of Cor were lower than those before operation(P<0.05),and the levels of SOD and GSH in the observation group were higher than those in the control group,and the level of Cor was lower than that in the control group(P<0.05).The amount of intraoperative bleeding in the observation group was less than that in the control group(P<0.05),and fracture healing time was shorter than that in the control group(P<0.05).Three months after surgery,the wrist function score in the observation group was lower than that in the control group(P<0.05).The incidence of postoperative complications in the observation group was lower than that in the control group(P<0.05).Conclusion Laryngeal mask anesthesia applied to patients undergoing internal fixation of limb fractures can reduce the patient’s stress response,helps to reduce intraoperative bleeding,fracture healing time,improve wrist function and reduce the incidence of complications,which is worthy of clinical promotion.