腰硬联合麻醉在单侧下肢骨关节手术患者中的应用效果分析

Application Effect Analysis of Combined Spinal-Epidural Anesthesia in Patients Undergoing Unilateral Lower Limb Bone Joint Surgery

目的:分析腰硬联合麻醉在单侧下肢骨关节手术患者中的应用效果。方法:选取2021年2月-2022年10月于建始县中医医院实施单侧下肢骨关节手术的患者80例作为研究对象,按照随机数字表法分为两组,各40例。对照组实施全身麻醉,观察组实施腰硬联合麻醉。比较两组疼痛程度、凝血功能指标、血流动力学指标。结果:术后6、12、24 h,两组疼痛评分逐渐降低,且观察组低于对照组,差异有统计学意义(P<0.05)。麻醉后4 h、术后24 h,两组凝血酶时间、凝血酶原时间、活化部分凝血活酶时间长于麻醉前,但观察组短于对照组,两组纤维蛋白原水平低于麻醉前,但观察组高于对照组,差异有统计学意义(P<0.05)。手术结束时,两组收缩压、舒张压、心率、血氧饱和度低于麻醉前,但观察组高于对照组,差异有统计学意义(P<0.05)。结论:腰硬联合麻醉在单侧下肢骨关节手术患者中的应用效果显著,可稳定血流动力学指标,减少对机体凝血功能的影响,缓解疼痛。

Objective:To analyze the application effect of combined spinal-epidural anesthesia in patients undergoing unilateral lower limb bone joint surgery.Methods:Eighty patients who underwent unilateral lower limb bone joint surgery at Jianshi Hospital of Traditional Chinese Medicine from February 2021 to October 2022 were selected as the study subjects.They were divided into two groups using a random number table method,with 40 patients in each group.The control group received general anesthesia,while the observation group received combined spinal-epidural anesthesia.The degree of pain,coagulation function indicators,and hemodynamic indicators were compared between two groups.Result:At 6,12 and 24 h after surgery,the pain scores in the two groups decreased gradually,and the scores in the observation group were lower than those in the control group,with a statistically significant difference(P<0.05).At 4 h after anesthesia and 24 h after surgery,the thrombin time,prothrombin time,and activated partial thromboplastin time in the two groups were longer than those before anesthesia,but these index in the observation group were shorter than those in the control group,while the fibrinogen level in the two groups was lower than that before anesthesia,but the level in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).At the end of the surgery,the systolic blood pressure,diastolic blood pressure,heart rate and oxygen saturation in the two groups were lower than those before anesthesia,but these indexes in the observation group were higher than those in the control group,and the difference was statistically significant(P<0.05).Conclusion:The application effect of combined spinal-epidural anesthesia in patients undergoing unilateral lower limb bone joint surgery is significant,which can stabilize hemodynamic indicators,reduce the impact on coagulation function of the body,and relieve the pain.