椎管内麻醉在老年下肢骨折患者中的应用效果

Application effect of intraspinal anesthesia in elderly patients with lower limb fracture

目的探讨椎管内麻醉在老年下肢骨折患者中的应用效果。方法选取2018年11月至2020年9月北票市中医院收治的84例拟行下肢骨折手术患者作为研究对象,按照随机数字表法分为研究组与对照组,各42例。对照组行全身麻醉,研究组行椎管内麻醉,比较两组围手术期指标、麻醉效果、简易智力状态检查量表(MMSE)评分及并发症发生率。结果研究组手术时间、睁眼时间、语言表达时间及下床活动时间均短于对照组,麻醉药物使用剂量少于对照组,差异有统计学意义(P<0.05)。两组优良率比较差异无统计学意义。术前,两组MMSE评分比较差异无统计学意义;术后,两组MMSE评分均低于术前,但研究组高于对照组,差异有统计学意义(P<0.05)。研究组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论椎管内麻醉对老年下肢骨折患者效果确切,能在获得良好麻醉效果的同时减少麻醉药物用量,减轻对患者认知功能的影响,且并发症少,安全性高,利于患者预后,值得临床推广应用。

Objective To explore the application effect of intraspinal anesthesia in elderly patients with lower limb fracture.Methods A total of 84 patients who underwent lower limb fracture surgery in Beipiao Traditional Chinese Medicine Hospital from November 2018 to September 2020 were selected as the research subjects,and they were divided into the study group and the control group according to the random number table meth-od,with 42 cases in each group.The control group received general anesthesia,and the study group received intraspinal anesthesia.The perioperative indexes,anesthesia effect,mini-mental state examination(MMSE)score and complication rate were compared between the two groups.Results The operation time,eye opening time,language expression time and ambulation time in the study group were shorter than those in the control group,and the dosage of anesthetic drugs was less than that in the control group,the differences were statistically significant(P<0.05).There was no significant difference in the excellent and good rate between the two groups.Before operation,there was no significant difference in MMSE score between the two groups;After operation,the MMSE scores of the two groups were lower than those before operation,but the study group was higher than the con-trol group,the difference was statistically significant(P<0.05).The incidence of complications in the study group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion Intraspinal anesthesia has a definite effect on elderly patients with lower limb fractures,it can achieve good anesthesia results while reducing the dosage of anesthetic drugs and reducing the impact on cognitive function,it has fewer complications,high safety,and is beneficial for patient prognosis,it is worthy of clinical promotion and application.