腰硬联合麻醉用于人工全膝关节置换术临床探讨.docVIP

腰硬联合麻醉用于人工全膝关节置换术临床探讨 　　[摘要] 目的 探讨腰硬联合麻醉用于人工全膝关节置换术的临床疗效。 方法 整群选取该院2013年1月―2015年1月期间外科人工全膝关节置换术患者98例，采用随机数字表法将其分为观察组与对照组，观察组50例，采用腰硬联合麻醉，对照组48例，采用全身麻醉。比较两组患者术后疼痛程度与手术期间血流动力学。 结果 观察组术后6、24、48 hVAS评分均明显低于对照组，下肢血流信号异常率明显低于对照组，比较差异有统计学意义（P0.05）。 结论 腰硬联合麻醉用于人工全膝关节置换术的临床疗效显著，有助于显著改善术后镇痛效果，降低血栓形成风险，值得临床推广应用。 　　[关键词] 腰硬联合麻醉；全身麻醉；人工全膝关节置换术 　　[中图分类号] R614 [文献标识码] A [文章编号] 1674-0742（2016）02（b）-0049-03 　　[Abstract] Objective To investigate the clinical effect of combined spinal-epidural anesthesia on artificial total knee arthroplasty. Methods 98 patients underwent artificial total knee arthroplasty in the Department of Surgery of our hospital from January 2013 to January 2015 were randomly divided into observation group and control group by random number table method. 50 cases in the observation group were treated by combined spinal-epidural anesthesia， and 48 cases in the control group were treated by general anesthesia. The postoperative pain and intraoperative hemodynamics in the two groups were compared. Results The VAS scores were much lower in the observation group than those in the control group 6 h， 24 h and 48 h after the surgery with statistically significant difference（P0.05）. Conclusion Combined spinal-epidural anesthesia applied to the artificial total knee arthroplasty has significant clinical curative effect， which is helpful to improve the postoperative analgesic effect and reduce the risk of thrombosis， so it is worthy of clinical application and promotion. 　　[Key words] Combined spinal-epidural anesthesia； General anesthesia； Artificial total knee arthroplasty 　　由于人工全膝关节置换术的手术时间较长，手术创伤程度高。大部分人工全膝关节置换术患者为中老年人，机体脏器功能逐渐衰退，手术耐受程度降低[1]。腰硬联合麻醉是一种新型的麻醉手段，其将脊椎麻醉与硬膜外麻醉相结合，具有强有效的镇痛的镇痛效果，且起效时间较短，有助于促进肌肉处于完全松弛状况。为了解腰硬联合麻醉在人工全膝关节置换术患者中的临床应用价值，该研究整群选取该院2013年1月―2015年1月期间外科98例人工全膝关节置换术患者作为研究对象，以探讨腰硬联合麻醉在人工全膝关节置换术中具有重要的意义，现报道如下。 　　1 资料与方法 　　1.1 一般资料 　　整群选取该院外科人工全膝关节置换术患者98例为研究对象，纳入标准：全部患者具有人工全膝关节置换术的手术适应证[2]；排除标准：合并肝肾功能障碍、凝血功能障碍、心力衰竭、静脉曲张、甲亢、糖尿病、血管手术史、肿瘤与精神性疾病患者。采用随