腰硬联合麻醉、全身麻醉在老年患者股骨颈骨折手术中的麻醉效果
|
摘要
目的观察腰硬联合麻醉、全身麻醉在老年患者股骨颈骨折手术中的麻醉效果。方法将2017年3月至2018年10月在本院行股骨颈骨折手术的72例老年患者随机分为观察组和对照组,各36例。对照组行全身麻醉,观察组行腰硬联合麻醉。比较两组的麻醉效果。结果麻醉后24 h,观察组的MMSE评分高于对照组,差异有统计学意义(P<0.05);观察组的术后VAS评分低于对照组,差异有统计学意义(P<0.05);观察组麻醉生效时间、意识恢复时间、住院时间均短于对照组,差异有统计学意义(P<0.05);观察组并发症总发生率为8.33%,显著低于对照组的27.78%,差异有统计学意义(P<0.05);观察组的麻醉镇痛优良率为94.44%,显著高于对照组的75.00%,差异有统计学意义(P<0.05)。结论相较于全身麻醉,腰硬联合麻醉在老年患者股骨颈骨折手术中具有更理想的麻醉效果,其有利于患者快速恢复意识,减轻疼痛,缩短住院时间,并发症发生率低且麻醉镇痛效果更好,是一种高效安全的麻醉方案,值得临床推广。
Objective To observe the anesthetic effect of combined spinal-epidural anesthesia and general anesthesia in the surgery of femoral neck fracture in elderly patients. Methods Seventy-two elderly patients who underwent femoral neck fracture surgery in our hospital from March 2017 to October 2018 were randomly divided into observation group and control group, with 36 cases in each group. The control group underwent general anesthesia and the observation group underwent combined spinal-epidural anesthesia. The anesthesia effects of the two groups were compared. Results At 24 hours after anesthesia, the MMSE score in the observation group was higher than that in the control group, and the difference was statistically significant(P<0.05). The postoperative VAS score of the observation group was lower than that of the control group, and the difference was statistically significant(P <0.05). The effective time of anesthesia, recovery time of consciousness and hospital stay in the observation group were shorter than those in the control group, and the differences were statistically significant(P<0.05). The total incidence of complications in the observation group was 8.33%, which was significantly lower than 27.78% of the control group, and the difference was statistically significant(P<0.05). The excellent and good rate of anesthesia and analgesia in the observation group was 94.44%, which was significantly higher than75.00% in the control group, and the difference was statistically significant(P<0.05). Conclusion Compared with general anesthesia, combined spinal-epidural anesthesia has better anesthetic effect in the femoral neck fracture surgery in elderly patients, which is beneficial to patients to quickly restore consciousness, reduce the pain and shorten hospital stay, with a low incidence of complications and better effect of analgesic and anesthesia. It is an effective and safe anesthetic scheme,which is worthy of clinical promotion.
Objective To observe the anesthetic effect of combined spinal-epidural anesthesia and general anesthesia in the surgery of femoral neck fracture in elderly patients. Methods Seventy-two elderly patients who underwent femoral neck fracture surgery in our hospital from March 2017 to October 2018 were randomly divided into observation group and control group, with 36 cases in each group. The control group underwent general anesthesia and the observation group underwent combined spinal-epidural anesthesia. The anesthesia effects of the two groups were compared. Results At 24 hours after anesthesia, the MMSE score in the observation group was higher than that in the control group, and the difference was statistically significant(P<0.05). The postoperative VAS score of the observation group was lower than that of the control group, and the difference was statistically significant(P <0.05). The effective time of anesthesia, recovery time of consciousness and hospital stay in the observation group were shorter than those in the control group, and the differences were statistically significant(P<0.05). The total incidence of complications in the observation group was 8.33%, which was significantly lower than 27.78% of the control group, and the difference was statistically significant(P<0.05). The excellent and good rate of anesthesia and analgesia in the observation group was 94.44%, which was significantly higher than75.00% in the control group, and the difference was statistically significant(P<0.05). Conclusion Compared with general anesthesia, combined spinal-epidural anesthesia has better anesthetic effect in the femoral neck fracture surgery in elderly patients, which is beneficial to patients to quickly restore consciousness, reduce the pain and shorten hospital stay, with a low incidence of complications and better effect of analgesic and anesthesia. It is an effective and safe anesthetic scheme,which is worthy of clinical promotion.
引文
[1]史春光,安慧霞,高峰.腰硬联合麻醉和全身麻醉在老年股骨颈骨折手术中效果对比[J].实用中西医结合临床,2018,18(3):114-116.
[2]李智海,张忠源,叶桂云.腰硬联合麻醉及全身麻醉在老年患者股骨颈骨折手术的麻醉浅析[J].中外医疗,2017,36(16):93-95.
[3]王栗霞.全身麻醉与腰硬联合麻醉在老年股骨颈骨折手术中的效果比较[J].中国实用医刊,2018,45(7):84-86.
[4]许芳芳.全身麻醉与腰硬联合麻醉在老年股骨颈骨折手术患者中的镇痛效果及安全性探讨[J].国际医药卫生导报,2017,23(23):3717-3720.
[5]赵丽青.硬腰联合麻醉和全身麻醉对老年股骨颈骨折手术患者的麻醉效果观察[J].淮海医药,2018,36(5):558-559.
[6]周爱莉.腰硬联合麻醉和全麻在老年患者股骨颈骨折手术中的麻醉效果[J].临床医学研究与实践,2017,2(30):52-53.
[7]张志莉.腰硬联合麻醉、全身麻醉在老年患者股骨颈骨折手术中的麻醉效果分析[J].当代医学,2018,24(14):115-117.
[8]陆远.浅析腰硬联合麻醉与全身麻醉在老年股骨颈骨折手术患者麻醉中的应用[J].中国伤残医学,2017,25(1):26-28.
[9]李秀娟.腰硬联合麻醉和全身麻醉在高龄股骨颈骨折患者中的应用比较[J].临床医学研究与实践,2017,2(12):77-78.
[10]李巍.腰硬联合麻醉与全身麻醉在老年股骨颈骨折手术中的应用作用比较[J].中国医药指南,2017,15(36):41-42.
[11]陈加云.腰硬联合麻醉和全身麻醉在老年患者股骨颈骨折手术中的麻醉观察[J].名医,2019,10(5):85.
[12]薛志刚.腰硬联合麻醉与全身麻醉在老年股骨颈骨折手术中的临床效果比较[J].临床医药文献电子杂志,2019,6(38):42.
[13]张春艳,冯康平,张新建.对接受手术治疗的老年股骨颈骨折患者进行腰硬联合麻醉与全身麻醉的效果对比[J].当代医药论丛,2019,17(7):81-82.
[14]李静.腰硬联合麻醉和全身麻醉在老年患者股骨颈骨折手术中的麻醉观察[J].中国医药指南,2019,17(6):83.
[2]李智海,张忠源,叶桂云.腰硬联合麻醉及全身麻醉在老年患者股骨颈骨折手术的麻醉浅析[J].中外医疗,2017,36(16):93-95.
[3]王栗霞.全身麻醉与腰硬联合麻醉在老年股骨颈骨折手术中的效果比较[J].中国实用医刊,2018,45(7):84-86.
[4]许芳芳.全身麻醉与腰硬联合麻醉在老年股骨颈骨折手术患者中的镇痛效果及安全性探讨[J].国际医药卫生导报,2017,23(23):3717-3720.
[5]赵丽青.硬腰联合麻醉和全身麻醉对老年股骨颈骨折手术患者的麻醉效果观察[J].淮海医药,2018,36(5):558-559.
[6]周爱莉.腰硬联合麻醉和全麻在老年患者股骨颈骨折手术中的麻醉效果[J].临床医学研究与实践,2017,2(30):52-53.
[7]张志莉.腰硬联合麻醉、全身麻醉在老年患者股骨颈骨折手术中的麻醉效果分析[J].当代医学,2018,24(14):115-117.
[8]陆远.浅析腰硬联合麻醉与全身麻醉在老年股骨颈骨折手术患者麻醉中的应用[J].中国伤残医学,2017,25(1):26-28.
[9]李秀娟.腰硬联合麻醉和全身麻醉在高龄股骨颈骨折患者中的应用比较[J].临床医学研究与实践,2017,2(12):77-78.
[10]李巍.腰硬联合麻醉与全身麻醉在老年股骨颈骨折手术中的应用作用比较[J].中国医药指南,2017,15(36):41-42.
[11]陈加云.腰硬联合麻醉和全身麻醉在老年患者股骨颈骨折手术中的麻醉观察[J].名医,2019,10(5):85.
[12]薛志刚.腰硬联合麻醉与全身麻醉在老年股骨颈骨折手术中的临床效果比较[J].临床医药文献电子杂志,2019,6(38):42.
[13]张春艳,冯康平,张新建.对接受手术治疗的老年股骨颈骨折患者进行腰硬联合麻醉与全身麻醉的效果对比[J].当代医药论丛,2019,17(7):81-82.
[14]李静.腰硬联合麻醉和全身麻醉在老年患者股骨颈骨折手术中的麻醉观察[J].中国医药指南,2019,17(6):83.