腰硬联合麻醉与硬膜外麻醉用于老年髋关节置换术临床对比分析.docVIP

腰硬联合麻醉与硬膜外麻醉用于老年髋关节置换术临床对比分析 　　[摘要] 目的 探讨老年髋关节置换术中腰硬联合麻醉与硬膜外麻醉的临床疗效。方法 方便选取该院在2014年12月―2015年10月期间所收治的行髋关节置换术74例老年患者作为该次研究对象，按照麻醉方式的不同，将其分为研究组和对照组，每组37例，对照组采取硬膜外麻醉，研究组行腰硬联合麻醉，对比分析两组患者麻醉后5、10、30 min的MAP与心率，观察两组麻醉起效时间与VAS评分，并详细记录两组使用镇静药与血管活性药物的情况。结果 研究组的麻醉起效平均时间（4.5±1.1）min显著短于对照组（10.2±3.4）min，研究组VAS评分（13.1±3.3）分低于对照组（18.9±4.5）分（t=9.720 4，6.322 2，P0.05），且两组在镇静剂与升压药物使用方面差异有统计学意义（χ2=5.232 3，5.045 5，2.055 6，P0.05）。结论 老年髋关节置换术中采取腰硬联合麻醉后，手术的镇痛效果较好，考虑患者为老年，麻醉方式适合老年患者，值得应用。 　　[关键词] 腰硬联合麻醉；硬膜外麻醉；髋关节置换术 　　[中图分类号] R4 [文献标识码] A [文章编号] 1674-0742（2018）03（b）-0092-03 　　Analysis of Clinical Comparison of Combined Spinal- epidural Analgesia and Epidural Anesthesia in Senile Patients with Hip Joint Replacement 　　QIN Guo-xin 　　Department of Anesthesia， Guangling District Hospital of TCM， Yangzhou， Jiangsu Province， 225000 China 　　[Abstract] Objective To study the clinical curative effect of combined spinal- epidural analgesia and epidural anesthesia in senile patients with hip joint replacement. Methods 74 cases of senile patients with hip joint replacement admitted and treated in our hospital from December 2014 to October 2015 were convenient selected as the research objects and divided into two groups with 37 cases in each according to different anesthesia methods， the control group and the research group were respectively treated with epidural anesthesia and combined spinal- epidural analgesia， and the MAP， and heart rate at 5min， 10min， and 30 min after anesthesia were compared between the two groups， and the anesthesia onset time and VAS score of the two groups were observed， and the sedatives usage and vasoactive agents of the two groups were recorded in detail. Results The average time of anesthesia onset in the research group was obviously shorter than that in the control group， [（10.2±3.4）min vs （4.5±1.1）min]， and the VAS score in the research group was lower than that in the control group[（13.1±3.3）points vs （18.9±4.5）points]，（t=9.720 4，6.322 2，P0.05）， and the differenc