全身麻醉下控制性降压对椎管减压融合内固定术患者术中出血量及术野的影响

Effect of Controlled Hypotension under General Anesthesia on Intraoperative Blood Loss and Surgical Field in Patients Undergoing Spinal Canal Decompression and Fusion with Internal Fixation

目的:探讨全身麻醉下控制性降压对椎管减压融合内固定术患者术中出血量及术野的影响。方法:选取2019年11月-2021年5月万载县中医院收治的需要进行椎管减压融合内固定术的60例腰椎退行性疾病患者,利用随机数字表法将其分为对照组、观察组,各30例。两组患者均在静吸复合全麻下接受手术治疗,观察组在术中接受硝酸甘油、乌拉地尔控制性降压。比较两组手术效果相关指标、术野质量评分、术后疗效。结果:观察组术中出血量、输血量、尿量、晶体液用量、胶体液用量均少于对照组,手术时间短于对照组(P<0.05)。在手术1、2 h和手术结束时,观察组的术野质量评分均低于对照组(P<0.05)。结论:针对腰椎退行性疾病患者,实施椎管减压融合内固定术治疗,并在术中应用全身麻醉下控制性降压,能够降低术中出血量,改善术中视野质量,提高康复效果。

Objective:To evaluate the effect of controlled hypotension under general anesthesia on intraoperative blood loss and surgical field in patients undergoing spinal canal decompression and fusion with internal fixation.Method:A total of 60 patients with lumbar degenerative diseases who needed spinal canal decompression and fusion with internal fixation admitted to Wanzai County Hospital of Traditional Chinese Medicine from November 2019 to May 2021 were selected,they were divided into control group and observation group with 30 cases in each group by random number table method.Both groups received surgical treatment under static aspiration combined with general anesthesia,and the observation group received Nitroglycerin and Urapidil controlled hypotension during the operation.The related indexes of operative effect,operative field quality score and postoperative efficacy were compared between the two groups.Result:The amount of intraoperative blood loss,blood transfusion,urine volume,amount of crystal fluid and amount of colloidal fluid in the observation group were less than those in the control group,and the operation time was shorter than that in the control group(P<0.05).At 1,2 h of surgery and at the end of surgery,the field quality scores in observation group were lower than those in control group(P<0.05).Conclusion:For patients with lumbar degenerative diseases,the implementation of spinal canal decompression and fusion with internal fixation,and the application of controlled hypotension under general anesthesia during the operation can reduce the amount of intraoperative bleeding,improve the quality of intraoperative vision,and improve the rehabilitation effect.