不同麻醉方式对老年嵌顿性股疝修补术患者的影响

Influence of Different Anesthesia Methods on Patients Undergoing Incarcerated Femoral Hernia Repair Surgery

目的:探究不同麻醉方式对老年嵌顿性股疝修补术患者的影响。方法:选取2021年1月-2024年1月南通市通州区中医院收治的102例老年嵌顿性股疝修补术患者。根据信封抽签法随机将其分为连续硬膜外麻醉(CEA)组和腰麻(SA)组,各51例。CEA组给予CEA,SA组给予SA。比较两组术中及术后1 h应激反应,术后24 h、48 h C反应蛋白(CRP)和白细胞计数(WBC),术后24 h、48 h、72 h疼痛程度,时间指标、并发症及治疗成本。结果:CEA组术中及术后1 h血糖、皮质醇水平均显著低于SA组,差异有统计学意义(P<0.05)。术后24 h、48 h,CEA组CRP水平均低于SA组,术后48 h,CEA组WBC低于SA组,差异有统计学意义(P<0.05)。CEA组术后24 h、48 h、72 h视觉模拟评分法(VAS)评分显著低于SA组,下床活动时间、肠功能恢复时间、住院时间均显著短于SA组,差异有统计学意义(P<0.05)。CEA组并发症发生率显著低于SA组,差异有统计学意义(P<0.05)。CEA麻醉费用及总治疗成本均多于SA组,药物费用少于SA组,差异有统计学意义(P<0.05)。结论:CEA用于老年嵌顿性股疝修补术在术后疼痛管理、恢复时间及并发症发生率方面优于SA,但治疗成本略高。患者应根据具体情况选择麻醉方式,有助于优化术后恢复效果和控制医疗费用。

Objective:To investigate the influence of different anesthesia methods on elderly patients undergoing incarcerated femoral hernia repair surgery.Method:A total of 102 elderly patients with incarcerated femoral hernia treated in Nantong Tongzhou District Hospital of Traditional Chinese Medicine from January 2021 to January 2024 were selected.They were randomly divided into continuous epidural anesthesia(CEA)group and spinal anesthesia(SA)group according to envelope drawing method,with 51 cases in each group.CEA group was given CEA,SA group was given SA.Stress reaction intraoperative and 1 h after surgery,C-reactive protein(CRP)and white blood cell count(WBC)24 h,48 h after surgery,pain degree at 24 h,48 h and 72 h after surgery,time index,complications and treatment cost were compared between the two groups.Result:The levels of blood glucose and cortisol in CEA group were significantly lower than those in SA group during surgery and 1 h after surgery,the differences were statistically significant(P<0.05).At 24 h and 48 h after surgery,CRP level in CEA group was lower than that in SA group,and WBC in CEA group was lower than that in SA group 48 h after surgery,the differences were statistically significant(P<0.05).Visual analogue scale(VAS)scores at 24 h,48 h and 72 h after surgery in CEA group were significantly lower than those in SA group,and the time of getting out of bed,intestinal function recovery time and hospital stay were significantly shorter than those in SA group,the differences were statistically significant(P<0.05).The incidence of complications in CEA group was significantly lower than that in SA group,the differences were statistically significant(P<0.05).The anesthesia cost and total treatment cost of CEA were higher than those of SA group,and the drug cost was lower than that of SA group,the differences were statistically significant(P<0.05).Conclusion:CEA is superior to SA in postoperative pain management,recovery time and complication incidence in elderly incarcerated femoral hernia repair surgery,but the treatment cost is slightly higher.Patients should choose the anesthesia method according to the specific situation,which is helpful to optimize the postoperative recovery effect and control medical costs.