探讨全麻和腰硬联合麻醉作用于髋关节置换术中的临床效果(1)
[摘要] 目的 分析全麻和腰硬联合麻醉在髋关节置换术中的应用效果。 方法 将2015年9月～2017年8月期间在我院接受髋关节置换术的50例患者进行分组研究，以随机分组的方法将患者分为观察组和对照组，各25例，对照组行全身麻醉，观察组行腰硬联合麻醉，比较两组的麻醉效果。 结果 资料统计显示，两组术后生命体征(收缩压、舒张压、心率)比较差异无统计学意义(P>0.05)；观察组麻醉指标(感觉阻滞时间、阻滞完善时间、疼痛恢复时间)均优于对照组，各项数据比较差异均有统计学意义(P<0.05)；观察组患者的不良反应发生率为8.00%(2/25)，明显低于对照组的28.00%(7/25)，两项数据比较有统计学意义(P<0.05)。 结论 全麻与腰硬联合麻醉在髋关节置换术中均能取得良好的效果，但相比之下腰硬联合麻醉的整体效果更好，值得在临床中借鉴并推广。
[关键词] 髋关节置换术；腰硬联合麻醉；全身麻醉；不良反应
[中图分类号] R614 [文献标识码] B [文章编号] 1673-9701(2018)17-0112-03
Clinical effect of general anesthesia and combined spinal-epidural anesthesia on hip arthroplasty
ZHANG Wei LIU Xingjin
Department of Anesthesiology， the First People's Hospital of Yidu City in Hubei Province， Yidu 443300， China
[Abstract] Objective To analyze the effect of general anesthesia and combined spinal-epidural anesthesia on hip arthroplasty. Methods A total of 50 patients undergoing hip arthroplasty in our hospital from September 2015 to August 2017 were selected and randomly divided into observation group and control group， with 25 patients in each group. General anesthesia was performed in the control group. The observation group underwent spinal-epidural anesthesia. We compared the anesthetic effects of the two groups. Results The data showed that there was no statistically significant difference in postoperative vital signs(systolic blood pressure， diastolic blood pressure and heart rate) between the two groups(P>0.05). Anesthesia index(sensory block time， block completion time， the recovery time of pain) in the observation group was statistically significant better than those of the control group(P<0.05). The incidence of adverse reactions in the observation group was 8.00%(2/25)， which was significantly lower than 28.00%(7/25) in the control group(P<0.05). Conclusion General anesthesia and combined spinal-epidural anesthesia can both achieve good curative effect in hip arthroplasty. While the general effect of combined spinal-epidural anesthesia is better which is worthy of using for reference and promotion in clinical practice.
[Key words] Hip arthroplasty； Combined spinal-epidural anesthesia； General anesthesia； Adverse reactions
髋关节置换术是现阶段临床上治疗髋关节及股骨头类疾病的常用手段；由于患者人群以老年人居多，在加上手术本身的创伤面积较大，因而手术中麻醉方法的选择就起到至关重要的作用。从过往临床情况来看，使用全身麻醉，患者在手术后易出现苏醒延迟等情况[1-2]，且各类并发症的发生率均比较高；为探寻最佳麻醉方法，本研究将以我院收治的50例患者进行分组研究，以比较当前使用率最高的全身麻醉与腰硬联合麻醉两种麻醉方法的临床效果，现报道如下。
1 资料与方法
1.1 一般资料
将2015年9月～2017年8月期间在我院接受髋关节置换术的50例患者进行分组研究；通过随机分组的方法将50例患者分为观察组(n=25)，男15例、女10例，年龄55～71岁，中位年龄62.4岁，体重51～72 kg，平均(63.3±5.1)kg；对照组(n=25)男14例、女11例，年齡52～74岁，中位年龄62.9岁，体重53～70 kg，平均体重(62.9±5.7)kg。研究经医院伦理会审核通过，患者对研究知情并签署同意书。两组年龄、性别、体重三项数据比较无差异(P>0.05)，符合研究要求。, http://www.100md.com(张微 刘兴进)
[关键词] 髋关节置换术；腰硬联合麻醉；全身麻醉；不良反应
[中图分类号] R614 [文献标识码] B [文章编号] 1673-9701(2018)17-0112-03
Clinical effect of general anesthesia and combined spinal-epidural anesthesia on hip arthroplasty
ZHANG Wei LIU Xingjin
Department of Anesthesiology， the First People's Hospital of Yidu City in Hubei Province， Yidu 443300， China
[Abstract] Objective To analyze the effect of general anesthesia and combined spinal-epidural anesthesia on hip arthroplasty. Methods A total of 50 patients undergoing hip arthroplasty in our hospital from September 2015 to August 2017 were selected and randomly divided into observation group and control group， with 25 patients in each group. General anesthesia was performed in the control group. The observation group underwent spinal-epidural anesthesia. We compared the anesthetic effects of the two groups. Results The data showed that there was no statistically significant difference in postoperative vital signs(systolic blood pressure， diastolic blood pressure and heart rate) between the two groups(P>0.05). Anesthesia index(sensory block time， block completion time， the recovery time of pain) in the observation group was statistically significant better than those of the control group(P<0.05). The incidence of adverse reactions in the observation group was 8.00%(2/25)， which was significantly lower than 28.00%(7/25) in the control group(P<0.05). Conclusion General anesthesia and combined spinal-epidural anesthesia can both achieve good curative effect in hip arthroplasty. While the general effect of combined spinal-epidural anesthesia is better which is worthy of using for reference and promotion in clinical practice.
[Key words] Hip arthroplasty； Combined spinal-epidural anesthesia； General anesthesia； Adverse reactions
髋关节置换术是现阶段临床上治疗髋关节及股骨头类疾病的常用手段；由于患者人群以老年人居多，在加上手术本身的创伤面积较大，因而手术中麻醉方法的选择就起到至关重要的作用。从过往临床情况来看，使用全身麻醉，患者在手术后易出现苏醒延迟等情况[1-2]，且各类并发症的发生率均比较高；为探寻最佳麻醉方法，本研究将以我院收治的50例患者进行分组研究，以比较当前使用率最高的全身麻醉与腰硬联合麻醉两种麻醉方法的临床效果，现报道如下。
1 资料与方法
1.1 一般资料
将2015年9月～2017年8月期间在我院接受髋关节置换术的50例患者进行分组研究；通过随机分组的方法将50例患者分为观察组(n=25)，男15例、女10例，年龄55～71岁，中位年龄62.4岁，体重51～72 kg，平均(63.3±5.1)kg；对照组(n=25)男14例、女11例，年齡52～74岁，中位年龄62.9岁，体重53～70 kg，平均体重(62.9±5.7)kg。研究经医院伦理会审核通过，患者对研究知情并签署同意书。两组年龄、性别、体重三项数据比较无差异(P>0.05)，符合研究要求。, http://www.100md.com(张微 刘兴进)