硬膜外麻醉与腰硬联合麻醉对高龄患者手术生命体征影响与安全性分析-

论文导读：ntlydecreased,andHRfluctuatedslightly,thereweresignificantdifferencesbetweenthetwogroups(P＜0.05).Thehypotension,bradycardia,nausea,vomitingandotheradversereactionsoftheobservationgroupweresignificantlylessthanthecontrolgroup(P＜0.05).ConclusionComparetoepidu
[摘要] 目的 探讨硬膜外麻醉与腰硬联合麻醉对高龄患者手术生命体征的影响，同时对安全性进行了对比。 方法 60例老年骨科手术患者随机为观察组与对照组，各30例，观察组采用腰硬联合麻醉，对照组采用硬膜外麻醉。测定并记录麻醉前后不同时间点的收缩压（SBP）、心率（HR）等血流动力学指标。观察两组麻醉前后的不良反应。 结果 观察组麻醉前后SBP与HR的变化都比较平稳，而对照组SBP有明显的下降，HR呈现波动，两组间相比差异有统计学意义（P ＜ 0.05）。观察组低血压、心动过缓、恶心、呕吐等不良反应明显少于对照组（P ＜ 0.05）。 结论 相对于硬膜外麻醉，腰硬联合麻醉应用于高龄手术患者能使血流动力学更加稳定，促进生命体征稳定，同时安全可靠，值得临床推广应用。
[关键词] 硬膜外麻醉；腰硬联合麻醉；老年人；血流动力学
[] A[文章编号] 1673-7210（2012）07（c）-0094-02
Safety analysis and vital signs effects of epidural anesthesia and combined spinal-epidural anesthesia in elderly patients with hip arthroplasty
ZHENG Kan
Department of Anesthesiology, Beijing Shijingshan Hospital, Beijing 100043, China
[Abstract] Objective To explore the safety and vital signs effects of epidural anesthesia and combined spinal-epidural anesthesia in elderly patients with hip arthroplasty. Methods 60 elderly patients with hip arthroplasty were randomly divided into the observation group and control group, the observation group were given combined spinal-epidural anesthesia, and the control group were only given epidural anesthesia. The systolic blood pressure (SBP), heart rate (HR) and other hemodynamic parameters were measured and recorded at different time before and after anesthesia. The adverse reactions of the two groups before and after anesthesia were observed. Results In the observation, the changes of SBP and HR 7彩论文网中专生毕业论文www.7ctime.com
before and after anesthesia were both relatively stable, while in the control group, SBP was significantly decreased, and HR fluctuated slightly, there were significant differences between the two groups (P ＜ 0.05). The hypotension, bradycardia, nausea, vomiting and other adverse reactions of the observation group were significantly less than the control group (P ＜ 0.05). Conclusion Compare to epidural anesthesia, combined spinal-epidural anesthesia used in patients with hip arthroplasty can make more stable hemodynamics, and promote vital signs stable, while is safe, reliable, and worthy of clinical application.
[Key words] Epidural anesthesia; Combined spinal-epidural anesthesia; Elderly; Hemodynamics
由于社会的老龄化，老年人的骨质疏松，因外伤引起的老年骨折患者越来越多。据统计，75岁以上老年人的手术约占手术量的10%以上。由于衰老导致机体一系列生理功能发生退化，容易诱发一系列的麻醉并发症，给老年患者的手术麻醉带来了极大的风险。当前我国人口老龄化问题越来越严重，老年手术也日益增多，由于老年人器官功能衰退，对麻醉提出了较高的要求。而硬膜外麻醉因其调控方便，可提供确切的肺通气和氧供，且不受体位的限制也得到较广泛的应用。而腰硬联合麻醉可以替代椎管内麻醉应用于髋部手术，对血流动力学影响轻微[3]。本文为此具体探讨了硬膜外麻醉与腰硬联合麻醉对高龄患者手术生命体征的影响与安全性影响。现报道如下：
1 资料与方法

1.1 一般资料

随机选择我院2008年2月～2011年9月收治的美国麻醉医师协会评级（ASA）Ⅰ～Ⅱ级择期髋关节置换手术的老年患者（年龄≥60岁）60例，男25例，女35例；年龄61～87岁；体重45～70 kg。在术前随机分为两组：观察组与对照组，各30例，两组一般资料比较差异无统计学意义（P ＞ 0.05），具有可比性。源于：7彩论文网毕业论文致谢范文www.7ctime.com