不同麻醉方式在老年人工股骨头置换术中的应用对比

Comparison of Application of Different Anesthesia Methods in Artificial Femoral Head Replacement in Elderly Patients

目的探讨不同麻醉方式在老年人工股骨头置换术中的应用。方法随机选取2021年3月—2022年12月闽侯县总医院麻醉科收治的90例老年人工股骨头置换术患者作为研究对象,按照其麻醉方式分连续硬膜外麻醉组(椎管组)、全身麻醉喉罩组(喉罩组)、全身麻醉插管组(插管组),各30例,所有患者均接受人工股骨头置换术治疗,比较3组患者麻醉质量、血流动力学指标、不良反应发生率。结果椎管组定向力恢复时间(11.82±2.32)min、睁眼时间(11.25±3.11)min短于喉罩组、插管组,插管组麻醉操作时间(17.06±1.52)min短于喉罩组、椎管组,差异有统计学意义(P<0.05)。3组患者在t0、t1、t2、t3、t4时收缩压(systolic blood pressure,SBP)、血氧饱和度(blood oxygen saturation,SpO_(2))指标比较,差异无统计学意义(P>0.05)。喉罩组不良反应发生率为0低于插管组的40.00%、椎管组的6.67%,差异有统计学意义(χ^(2)=4.007,P<0.05)。结论相比于连续硬膜外麻醉、插管全身麻醉,喉罩全身麻醉对老年人工股骨头置换术的麻醉质量、安全性均更理想。

Objective To explore the application of different anesthesia methods in artificial femoral head replacement in the elderly.Methods A total of 90 elderly patients undergoing artificial femoral head replacement treated in the anesthesiology Department of Minhou County General Hospital from March 2021 to December 2022 were randomly selected as the study objects.According to their anesthesia methods,they were divided into continuous epidural anesthesia group(spinal canal group),general anesthesia laryngeal mask group(laryngeal mask group)and general anesthesia intubation group(intubation group),with 30 cases each.All patients were treated with artificial femoral head replacement.Anesthetic quality,hemodynamic indexes and incidence of adverse reactions were compared among the three groups.Results The orientation recovery time(11.82±2.32)min and the eye opening time(11.25±3.11)min in the spinal canal group were shorter than those in the laryngeal mask group and the intubation group,and the anesthesia operation time(17.06±1.52)min in the intubation group was shorter than those in the laryngeal mask group and the spinal canal group,the difference was statistically significant(P<0.05).Systolic blood pressure(SBP)and blood oxygen saturation(SpO_(2))indexes at t0,t1,t2,t3 and t4 were compared among three groups,and the difference was no statistically significant(P>0.05).The incidence of adverse reactions in laryngeal mask group(0)was lower than that in intubation group(40.00%)and spinal canal group(6.67%),and the difference was statistically significant(χ^(2)=4.007,P<0.05).Conclusion Compared with continuous epidural anesthesia and intubation general anesthesia,laryngeal mask general anesthesia is more ideal for the quality and safety of artificial femoral head replacement in the elderly.