小剂量轻比重腰麻—硬膜外联合麻醉应用于老年下肢骨折手术中的效果分析(1)
[摘要] 目的 分析小剂量轻比重腰麻-硬膜外联合麻醉应用于老年下肢骨折手术中的临床效果。 方法 选取我院2013年12月20日～2015年3月20日收诊的老年下肢骨折且行手术的患者66例，采用数字随机法，分成观察组(n=33)和对照组(n=33)，对照组采取连续硬膜外麻醉，观察组则采取小剂量轻比重腰麻-硬膜外联合麻醉，比较两组的麻醉效果。 结果 观察组的药品剂量少于对照组，差异有统计学意义(P<0.05)。观察组的阻滞完善时间、麻醉起效时间均短于对照组，差异有统计学意义(P<0.05)。观察组的优秀率高于对照组，良好率低于对照组，差异有统计学意义(P<0.05)。观察组的不良反应发生率为6.06%，对照组为48.48%，观察组的不良反应发生率低于对照组，差异有统计学意义(P<0.05)。 结论 小剂量轻比重腰麻-硬膜外麻醉效果令人满意，且安全性较高，十分适用于老年人下肢骨折患者。
[关键词] 腰麻-硬膜外联合麻醉；老年；下肢骨折；手术
[中图分类号] R274.12 [文献标识码] A [文章编号] 1674-4721(2016)01(c)-0046-03
[Abstract] Objective To analyze the clinical effect of small dose and light specific gravity of combined spinal epidural anesthesia applied in lower limb fracture surgery in elderly patients. Methods 66 elderly patients receiving lower limb fracture surgery in our hospital from December 20，2013 to March 20，2015 were selected and randomly divided into observation group (n=33) and control group (n=33).Control group was given continuous epidural anesthesia while observation group was given small dose and light specific gravity of combined spinal epidural anesthesia.The anesthetic effect between two groups was compared. Results The drug dose used in observation group was lower than that in control group，and there was a statistical difference (P<0.05).The time of maximum sensory block and time of anesthesia onset in observation group was significantly shorter than that in control group respectively，and there was a statistical difference (P<0.05).The excellent rate in observation group was higher than that in control group，and the good rate was lower than that in control group，and there was a statistical difference (P<0.05).The incidence rate of adverse reaction in observation group (6.06%) was lower than that of control group (48.48%)，and there was a statistical difference (P<0.05). Conclusion Small dose and light specific gravity of combined spinal epidural anesthesia has a satisfactory effect with high safety，which is very appropriate for elderly patients with lower limb fracture.
[Key words] Combined spinal epidural anesthesia；Old age；Lower limb fracture；Surgery
老年下肢骨折患者的麻醉方式选择一直是临床研究人员关心的问题，既需要考虑到麻醉效果，也需要顾及老年人的麻醉耐受能力[1]。常用的腰麻和硬膜外麻醉均具有一定的弊端，腰麻起效快，但不够安全，而硬膜外麻醉虽然安全性可以保证，但起效较慢，患者痛苦时间会延长，因此均需要进行改进[2]。将两者的优势进行结合的小剂量轻比重腰麻-硬膜外麻醉是一种新型的麻醉方法，其可在满足麻醉需求的基础上，将麻醉的危险性降到最低，因此其属于老年人的适宜麻醉方法，用在下肢骨折治疗中可保证手术顺利进行。本研究对小剂量轻比重腰麻-硬膜外麻醉的效果进行分析，现报道如下。
1 资料与方法
1.1 一般资料
选取我院2013年12月20日～2015年3月20日收诊的老年下肢骨折且行手术的患者66例，采用数字随机法，分成观察组和对照组，观察组33例，其中男18例，女15例，年龄为60～79岁，平均(68.9±2.9)岁，体重62～73 kg，平均(67.1±1.7)kg；对照组33例，其中男19例，女14例，年龄为60～77岁，平均(68.7±2.9)岁，体重63～73 kg，平均(67.2±1.7)kg。两组患者的一般资料比较，差异无统计学意义(P>0.05)，具有可比性。, 百拇医药(马涛)
[关键词] 腰麻-硬膜外联合麻醉；老年；下肢骨折；手术
[中图分类号] R274.12 [文献标识码] A [文章编号] 1674-4721(2016)01(c)-0046-03
[Abstract] Objective To analyze the clinical effect of small dose and light specific gravity of combined spinal epidural anesthesia applied in lower limb fracture surgery in elderly patients. Methods 66 elderly patients receiving lower limb fracture surgery in our hospital from December 20，2013 to March 20，2015 were selected and randomly divided into observation group (n=33) and control group (n=33).Control group was given continuous epidural anesthesia while observation group was given small dose and light specific gravity of combined spinal epidural anesthesia.The anesthetic effect between two groups was compared. Results The drug dose used in observation group was lower than that in control group，and there was a statistical difference (P<0.05).The time of maximum sensory block and time of anesthesia onset in observation group was significantly shorter than that in control group respectively，and there was a statistical difference (P<0.05).The excellent rate in observation group was higher than that in control group，and the good rate was lower than that in control group，and there was a statistical difference (P<0.05).The incidence rate of adverse reaction in observation group (6.06%) was lower than that of control group (48.48%)，and there was a statistical difference (P<0.05). Conclusion Small dose and light specific gravity of combined spinal epidural anesthesia has a satisfactory effect with high safety，which is very appropriate for elderly patients with lower limb fracture.
[Key words] Combined spinal epidural anesthesia；Old age；Lower limb fracture；Surgery
老年下肢骨折患者的麻醉方式选择一直是临床研究人员关心的问题，既需要考虑到麻醉效果，也需要顾及老年人的麻醉耐受能力[1]。常用的腰麻和硬膜外麻醉均具有一定的弊端，腰麻起效快，但不够安全，而硬膜外麻醉虽然安全性可以保证，但起效较慢，患者痛苦时间会延长，因此均需要进行改进[2]。将两者的优势进行结合的小剂量轻比重腰麻-硬膜外麻醉是一种新型的麻醉方法，其可在满足麻醉需求的基础上，将麻醉的危险性降到最低，因此其属于老年人的适宜麻醉方法，用在下肢骨折治疗中可保证手术顺利进行。本研究对小剂量轻比重腰麻-硬膜外麻醉的效果进行分析，现报道如下。
1 资料与方法
1.1 一般资料
选取我院2013年12月20日～2015年3月20日收诊的老年下肢骨折且行手术的患者66例，采用数字随机法，分成观察组和对照组，观察组33例，其中男18例，女15例，年龄为60～79岁，平均(68.9±2.9)岁，体重62～73 kg，平均(67.1±1.7)kg；对照组33例，其中男19例，女14例，年龄为60～77岁，平均(68.7±2.9)岁，体重63～73 kg，平均(67.2±1.7)kg。两组患者的一般资料比较，差异无统计学意义(P>0.05)，具有可比性。, 百拇医药(马涛)