椎管内麻醉与全身麻醉对高龄股骨粗隆间骨折患者术后恢复的影响(1)
【摘要】 目的：分析椎管内麻醉与全身麻醉对高龄股骨粗隆间骨折患者术后恢复的影响。方法：选择104例接受手术治疗的高龄股骨粗隆间骨折患者为研究对象，根据麻醉方法的不同将其分为全麻组(n=49)、椎管组(n=55)，分别行全身麻醉、椎管内麻醉，比较两组手术指标、术后恢复情况、并发症发生情况及麻醉满意度。结果：两组麻醉生效时间、术中出血量比较，差异无统计学意义(P>0.05)。椎管组术后下床活动时间、住院时间均短于全麻组，差异有统计学意义(P<0.05)。椎管组术后并发症发生率低于全麻组，差异有统计学意义(P<0.05)。椎管组对麻醉方法的满意度高于全麻组，差异有统计学意义(P<0.05)。结论：高龄股骨粗隆间骨折患者手术中，椎管内麻醉相对于全身麻醉，更有助于促进患者的术后恢复。
【关键词】 椎管内麻醉; 全身麻醉; 高龄股骨粗隆间骨折患者; 术后恢复
doi：10.14033/j.cnki.cfmr.2019.23.008 文献标识码 B 文章编号 1674-6805(2019)23-00-03
【Abstract】 Objective：To analyze the effects of intravertebral anesthesia and general anesthesia on postoperative recovery of elderly patients with intertrochanteric fracture.Method：A total of 104 elderly patients with intertrochanteric fracture who underwent surgical treatment were selected as study subjects.They were divided into general anesthesia group(n=49) and spinal canal group(n=55) according to different anesthesia methods.General anesthesia and intravertebral anesthesia were performed respectively.The surgical indexes，postoperative recovery，complications and satisfaction with anesthesia were compared between the two groups.Result：There was no significant difference in the effective time of anesthesia and intraoperative blood loss between the two groups(P>0.05).The time of getting out of bed and hospitalization in the spinal canal group were shorter than those in the general anesthesia group，the differences were statistically significant(P<0.05).The incidence of postoperative complication in the spinal canal group was lower than that in the general anesthesia group，the difference was statistically significant(P<0.05).The satisfaction of the spinal canal group with anesthesia was higher than that of the general anesthesia group，the difference was statistically significant(P<0.05).Conclusion：In elderly patients with intertrochanteric fracture，intraspinal anesthesia is more conducive to postoperative recovery than general anesthesia.
【Key words】 Intraspinal anesthesia; General anesthesia; Elderly patients with intertrochanteric fracture; Postoperative recovery
First-author’s address：Zhaotong Second People’s Hospital，Zhaotong 657000，China
股骨粗隆間骨折为临床常见的一种骨折，多见于老年人群体[1]。近年来，手术治疗的不断发展，使得髓内钉内固定术逐渐用于高龄股骨粗隆间骨折患者的治疗中。既往手术经验证实，采用不同麻醉方法实施手术，高龄患者的术后恢复速度存在一定差异[2]。为了对比椎管内麻醉与全身麻醉对高龄股骨粗隆间骨折患者术后恢复的价值，本研究对104例患者进行分析，现报道如下。
1 资料与方法
1.1 一般资料
选择笔者所在医院2017年1月-2018年10月收治的104例接受手术治疗的高龄股骨粗隆间骨折患者为研究对象。纳入标准：(1)符合股骨粗隆间骨折诊断标准;(2)均接受股骨防旋髓内钉内固定术治疗。排除标准：(1)年龄<60岁;(2)不配合的患者。依据麻醉方法的不同将其分为全麻组(49例)、椎管组(55例)。全麻组男28例，女21例;平均年龄(69.2±2.6)岁。椎管组男30例，女25例;平均年龄(69.4±2.7)岁。两组一般资料比较差异无统计学意义(P>0.05)，有可比性。所有患者均对本研究知情同意。, http://www.100md.com(彭国才)
【关键词】 椎管内麻醉; 全身麻醉; 高龄股骨粗隆间骨折患者; 术后恢复
doi：10.14033/j.cnki.cfmr.2019.23.008 文献标识码 B 文章编号 1674-6805(2019)23-00-03
【Abstract】 Objective：To analyze the effects of intravertebral anesthesia and general anesthesia on postoperative recovery of elderly patients with intertrochanteric fracture.Method：A total of 104 elderly patients with intertrochanteric fracture who underwent surgical treatment were selected as study subjects.They were divided into general anesthesia group(n=49) and spinal canal group(n=55) according to different anesthesia methods.General anesthesia and intravertebral anesthesia were performed respectively.The surgical indexes，postoperative recovery，complications and satisfaction with anesthesia were compared between the two groups.Result：There was no significant difference in the effective time of anesthesia and intraoperative blood loss between the two groups(P>0.05).The time of getting out of bed and hospitalization in the spinal canal group were shorter than those in the general anesthesia group，the differences were statistically significant(P<0.05).The incidence of postoperative complication in the spinal canal group was lower than that in the general anesthesia group，the difference was statistically significant(P<0.05).The satisfaction of the spinal canal group with anesthesia was higher than that of the general anesthesia group，the difference was statistically significant(P<0.05).Conclusion：In elderly patients with intertrochanteric fracture，intraspinal anesthesia is more conducive to postoperative recovery than general anesthesia.
【Key words】 Intraspinal anesthesia; General anesthesia; Elderly patients with intertrochanteric fracture; Postoperative recovery
First-author’s address：Zhaotong Second People’s Hospital，Zhaotong 657000，China
股骨粗隆間骨折为临床常见的一种骨折，多见于老年人群体[1]。近年来，手术治疗的不断发展，使得髓内钉内固定术逐渐用于高龄股骨粗隆间骨折患者的治疗中。既往手术经验证实，采用不同麻醉方法实施手术，高龄患者的术后恢复速度存在一定差异[2]。为了对比椎管内麻醉与全身麻醉对高龄股骨粗隆间骨折患者术后恢复的价值，本研究对104例患者进行分析，现报道如下。
1 资料与方法
1.1 一般资料
选择笔者所在医院2017年1月-2018年10月收治的104例接受手术治疗的高龄股骨粗隆间骨折患者为研究对象。纳入标准：(1)符合股骨粗隆间骨折诊断标准;(2)均接受股骨防旋髓内钉内固定术治疗。排除标准：(1)年龄<60岁;(2)不配合的患者。依据麻醉方法的不同将其分为全麻组(49例)、椎管组(55例)。全麻组男28例，女21例;平均年龄(69.2±2.6)岁。椎管组男30例，女25例;平均年龄(69.4±2.7)岁。两组一般资料比较差异无统计学意义(P>0.05)，有可比性。所有患者均对本研究知情同意。, http://www.100md.com(彭国才)