全身插管麻醉与腰硬联合麻醉对于老年股骨颈骨折患者术后肺部并发症影响.docVIP

全身插管麻醉与腰硬联合麻醉对于老年股骨颈骨折患者术后肺部并发症影响 　　[摘要] 目的 探讨全身插管麻醉与腰硬连麻麻醉对老年股骨颈骨折患者术后肺部并发症的影响。方法 随机选取2013年2月―2016年8月该院收治的100例股骨颈骨折患者为研究对象，依照麻醉方式不同将入选病例分为A组（全身插管麻醉，47例）和B组（腰硬联合麻醉，53例）。观察两组肺部并发症发生率，评估两组肺部感染情况。结果 A组肺部感染并发症发生率（26.77%）显著高于B组（9.43%），差异有统计学意义（P0.05）。结论 老年股骨颈骨折术中应用腰硬联合麻醉对减少术后肺部感染并发症发生率具有积极作用，值得临床推广使用。 　　[关键词] 股骨颈骨折；全身插管麻醉；腰硬联合麻醉；肺部并发症 　　[中图分类号] R614 [文献标识码] A [文章编号] 1674-0742（2017）04（c）-0094-03 　　[Abstract] Objective To discuss the effect of general intubation anesthesia and combined spinal epidural anesthesia on the postoperative lung complications of senile patients with transcervical fracture. Methods 100 cases of patients with transcervical fracture admitted and treated in our hospital from February 2013 to August 2016 were randomly selected and divided into two groups according to the anesthesia methods， the group A with 47 cases adopted the general intubation anesthesia， while the group B with 53 cases adopted the combined spinal epidural anesthesia， and the incidence rate of lung complications of the two groups was observed and the lung infection situation of the two groups was evaluated. Results The incidence rate of lung infection complications in the group A was obviously higher than that in the group B（26.77% vs 9.43%）， and the difference was statistically significant（P0.05）. Conclusion The application of combined spinal epidural anesthesia for senile patients with transcervical fracture can reduce the incidence rate of postoperative lung infection complications， which is worth clinical promotion and application. 　　[Key words] Franscervical fracture； General intubation anesthesia； Combined spinal epidural anesthesia； Lung complication 　　麻醉是临床手术的重要步骤，是确保手术顺利实施的关键[1]。目前，临床手术治疗股骨颈骨折主要采用全身插管麻醉或腰硬联合麻醉，但是老年人由于免疫功能下降、呼吸系统退行性改变、手术创伤打击等原因，对麻醉耐受性较差，麻醉风险也相对较高[2]。文章现以2013年2月―2016年8月该院收治的100例老年股骨颈骨折患者为例，分析上述两种麻醉方法对患者术后肺部并发症的影响，现报道如下。 　　1 资料与方法 　　1.1 一般资料 　　随机选取该院收治的100例股骨颈骨折患者为研究对象，依照麻醉方式不同将入选病例分为两?M。A组（47例）：男24例，女23例；平均年龄（84.8±5.1）岁；平均手术时间（105.4±14.7）min； ASA麻醉分