探讨腰麻―硬膜外联合阻滞麻醉与单纯硬膜外麻醉临床麻醉效果.docVIP

探讨腰麻―硬膜外联合阻滞麻醉与单纯硬膜外麻醉临床麻醉效果 　　DOI：10.16662/j.cnki.1674-0742.2017.23.090 　　[摘要] 目的 评价腰麻-硬膜外联合阻滞麻醉与单纯硬膜外麻醉的临床麻醉效果。 方法 方便选取2016年1月―2017年2月，重庆市武警重庆市消防总队医院普外科、骨外科等科室收治的下肢手术患者90例，黑箱摸球分组，42例纳入硬膜外组，48例纳入腰硬组。对比血压变化差值、?g后腰痛VAS水平、不良事件发生情况。结果 腰硬组手术期间HR、SBP、DBP峰值与谷值差值分别为（7.54±1.65）次/min、（17.43±5.58）mmHg、（13.65±5.16）mmHg低于硬膜外组（11.47±5.51）次/min、（23.52±6.33）mmHg、（18.26±5.46）mmHg，腰硬组术后腰痛VAS评分（1.3±0.5）分、术中呼吸循环紊乱发生率22.92%低于硬膜外组（2.5±1.0）分、57.14%，差异有统计学意义（P0.05）。结论 下肢手术更适合腰麻-硬膜外联合阻滞麻醉。 　　[关键词] 下肢手术；硬膜外麻醉；腰硬联合阻滞麻醉 　　[中图分类号] R614 [文献标识码] A [文章编号] 1674-0742（2017）08（b）-0090-03 　　Analysis of the Clinical Anesthesia Effect of Combined Spinal Epidural Anesthesia and Epidural Anesthesia 　　FENG Shu-zhong， ZHAO Jian-zhong， TANG Hang， HE Zhen， JIANG Mao-ting 　　Department of Anesthesiology， Chongqing Armed Police Fire Corps Hospital， Chongqing， 401122 China 　　[Abstracts] Objective This paper tries to evaluate the clinical anesthesia effect of combined spinal epidural anesthesia and epidural anesthesia. Methods 90 cases of lower limb surgery treated in department of general surgery and orthopedics department in this hospital from January 2016 to February 2017 were convenient selected and grouped by choosing the ball in the black box， 42 cases in epidural anesthesia group， and 48 cases in spinal epidural group. The difference of blood pressure， postoperative low back pain VAS level and adverse events of both groups were compared. Results The different value of HR， SBP， DBP between peak and valley in the spinal epidural group were（7.54±1.65）times/min，（17.43±5.58） mmHg，（13.65±5.16） mmHg， lower than that of the epidural anesthesia group of（11.47±5.5 1）times/min，（23.52±6.33） mmHg，（18.26±5.46） mmHg， the low back pain VAS score was（1.3±0.5）points， incidence of respiratory and circulatory disorder was 22.92% in the spinal epidural group， lower than that of the epidural group of （2.5±1.0）points and 57.14%， the difference was statistically significant（P0.05）. Conclusion The spinal epidural anesthesi