不同麻醉方法用于髌骨骨折爪取出术观察.docVIP

不同麻醉方法用于髌骨骨折爪取出术的观察 　　摘要：目的 观察连续硬膜外麻醉和静脉麻醉用于髌骨骨折爪取出术麻醉效果。方法 50例ASAI-Ⅱ级拟行髌骨骨折爪取出术的患者，随机分为R组硬膜外麻醉组和F组静脉麻醉组。分别记录两组包括患者进入手术室到手术开始时间，麻醉及手术时患者心率血压变化，并观察不良反应等。结果 F组患者比R组舒适度高，血流动力学稳定，不良反应少。结论 连续硬膜外麻醉和静脉麻醉都能满足髌骨骨折爪取出术需要，静脉麻醉对患者更舒适，麻醉恢复快，不良反应少。 　　关键词：静脉麻醉；硬膜外麻醉；髌骨内固定取出术；心率血压变化 　　 Different Methods of Anesthesia for to Observe the Removal of Jaws of the Patella Fracture 　　LIN Li 　　(Department of Anesthesiology, The Sixth Peoples Hospital of Chengdu City, Chengdu 610051,Sichuan,China) 　　Abstract：ObjectiveTo observe the effect of continuous epidural anesthesia and intravenous anesthesia for fracture of patella claw removal surgery anesthesia. Methods50 cases of ASAI~Ⅱundergoing patellar fracture patients with removal of jaws, were randomly divided into R groupepidural anesthesia group and F group were intravenous anesthesia. The two groups were recorded including patients into the operation room to the operation start time, changes in theheart rate and blood pressure during anesthesia and operation, and the adverse reactions were observed. ResultsThe patients in group F than in group R high comfort, stability of hemodynamics, and less adverse reaction. ConclusionThe continuous epidural anesthesia andintravenous anesthesia can meet the fracture of patella claw removal, intravenous anesthesia onanesthesia patients more comfortable, faster recovery, less adverse reaction. 　　Key words：Intravenous anesthesia; Epidural anesthesia; Internal fixation of patella removal;Heart rate and blood pressure changes 　　髌骨是人体中最大的籽骨。也是膝关节重要组成部分，起到保护膝关节的作用。髌骨骨折爪内固定术应用广泛。它安装方便，易于调节，固定牢靠，可早期功能锻炼，防止关节粘连僵硬和股四头肌力减退，可避免针尾刺破皮肤导致感染。髌骨骨折爪取出也快速方便，创伤小、见效快、并发症少，手术效果好越来越被众多患者认可，满足时代需要。我院髌骨骨折爪取出术以往常采用连续硬膜外麻醉。患者常觉麻醉穿刺疼痛不适，术后穿刺点疼痛，患者内心对麻醉有些不安而且对第二次手术麻醉的焦虑。因此麻醉方式的调整大大减轻患者的痛苦和不安。减少穿刺的疼痛，更加舒适，患者接受度高。 　　1资料与方法 　　1.1一般资料选择50例择期ASA I～Ⅱ级施行髌骨骨折爪取出手术的患者，年龄25~55岁，体重45~75?K,排出心、肺、肝、肾脏病变。均采取仰卧位。将患者随机分为两组每组25例。分别为：硬膜外麻醉(R)组；静脉麻(F)组。两组患者的一般情况包括年龄、性别、体重、手术时间等无大差异(见表1)。对两组患者的一般情况进行比较，两组患者一般情况基本一致。采用两组间t检验的方法，两组患者其年龄和性别之间