两种麻醉方式在老年骨伤患者中的疗效对比

Comparison of the efficacy of two kinds of anesthesia in elderly patients with bone fracture

目的:探析椎管内麻醉术和全身麻醉术在老年骨伤患者中的临床疗效。方法:分析2014年2月~2016年11月在我院接受手术治疗的82例老年骨伤患者的临床资料。根据麻醉方式的不同,将入选者分成观察组(椎管内麻醉,42例)和对照组(全身麻醉,40例)两组。比较两组患者的基线资料、手术情况、手术前后的简易智能精神状态检查量表(MMSE)评分及P3潜伏期、P3波幅。结果:两组患者的基线资料无显著统计学差异。观察组患者的手术时间、麻醉用药量、睁眼时间及语言陈述时间均显著低于对照组。术前及术后12、24h时两组患者的MMSE评分、P3潜伏期与P3波幅无显著统计学差异,术后1、3、6h时观察组患者的MMSE评分及P3波幅显著高于对照组,P3潜伏期显著低于对照组。结论:椎管内麻醉在老年骨伤患者中的疗效较为理想,不但可以明显使患者麻醉用药量大大降低、手术时间及睁眼时间及语言陈述时间减少,还对患者术后的认知功能及精神状态较全身麻醉术影响更低,值得推广。

Objective Our retrospective study was aimed toanalyze the efficacy of general anesthesia and spinal anesthesia in the elderly patients with bone fracture. Methods Clinical data of 82 elderly patients with bone fracturereceived treatment at our hospitalfrom February, 2014 to November, 2016 was retrospectivelyanalyzed. Patients included were divided into two groups according to the different anesthesia, observe group(spinal anesthesia, 42 cases) and control group(general anesthesia, 40 cases). The general information, the operation situation, the MMSE scores and the incubation period of P3 and P3 amplitude before and after operation in two groups were compared. Results The general information in two groups had no statistical difference. The operation time, the anesthetic dosage, the eye opening time and the language stated time in observe group were obviously lower than those in control group. The MMSE scores, the incubation period of P3 and P3 amplitude before treatment, at 12 h and 24 h after operation in two groups had no statistical difference. The MMSE scores, the P3 amplitude in observe group at 1 h, 3 h, 6 h after operation were obviously higher than those in control group, and the incubation period of P3 in observe group at 1 h, 3 h, 6 h after operation were obviously lower than those in control group. Conclusion The efficacy of spinal anesthesia in elderly patients with bone fracture is satisfactory. The spinal anesthesia could significantly shorten the operation time, the anesthetic dosage, the eye opening time and the language stated time and lower the effect on the cognitive function and the mental status, which is worth promoting.