腰硬联合麻醉在90岁以上老年患者股骨粗隆间骨折手术的临床观察

发布时间：2018-01-04 18:39

本文关键词：腰硬联合麻醉在90岁以上老年患者股骨粗隆间骨折手术的临床观察　出处：《河北医学》2016年09期 　论文类型：期刊论文

【摘要】：目的:探讨腰硬联合麻醉在90岁以上老年患者股骨粗隆间骨折手术的应用效果。方法:选择48例90岁以上择期行股骨粗隆间骨折手术者,观察组予以腰麻-硬膜外联合麻醉,对照组予以硬膜外麻醉,每组各24例。观察两组患者手术情况、不同时间点血压与心率变化以及分别采用针刺法进行感觉阻滞评估,改良Bromage评分法进行运动阻滞评价。结果:与对照组比较,观察组患者的麻醉起效时间、用药量均降低明显,差异有统计学意义(P0.05),感觉运动阻滞中的起效时间缩短明显,最大感觉阻滞平面以及最大感觉阻滞时间均增加明显,运动阻滞中的起效时间、最大运动阻滞时间均缩短明显,差异有统计学意义(P0.05)。在T0~4时间段上两组患者的DBP、SBP以及HR比较均无统计学意义(P0.05)。结论:在90岁以上老年患者股骨粗隆间骨折手术中应用腰硬联合麻醉不仅用药量低,可较好的维持术中血压以及心率,效果确切,而且可对于感觉与运动进行有效阻滞,安全性较高。
[Abstract]:Objective: to investigate the effect of combined spinal-epidural anesthesia on intertrochanteric fracture of femur in elderly patients over 90 years old. Methods: 48 patients with intertrochanteric fracture of femur over 90 years old were selected. The observation group was given combined spinal-epidural anesthesia and the control group was given epidural anesthesia with 24 cases in each group. The changes of blood pressure and heart rate at different time points and sensory block were evaluated by acupuncture, and motor block was evaluated by modified Bromage score. Results: compared with control group. In the observation group, the onset time and dosage of anesthesia were significantly decreased, the difference was statistically significant (P 0.05), and the onset time of sensory motor block was shortened obviously. The maximum sensory block level and the maximum sensory block time were significantly increased, the onset time of motor block and the maximum motor block time were significantly shortened. The difference was statistically significant (P 0.05). The DBP of the two groups was at the time of T0 / 4. There was no significant difference in SBP and HR. Conclusion: combined spinal-epidural anesthesia is not only used in the operation of femoral intertrochanteric fracture in elderly patients over 90 years old. It can maintain intraoperative blood pressure and heart rate effectively, and can block sensation and movement effectively.
【作者单位】：北京市顺义区医院麻醉科;
【基金】：中华医学会麻醉学分会力邦麻醉科学研究基地科研项目,(编号:CSA2013LB009)
【分类号】：R614
【正文快照】： 我科自2012年以来,采用腰硬联合麻醉措施应用于90岁以上高龄患者股骨粗隆间骨折手术之中,效果甚佳,现将结果汇报如下:1资料与方法1.1研究对象:2012年3月至2014年3月将我科收治的48例90岁以上择期行股骨粗隆间骨折手术者作为研究对象,纳入本项目之中。纳入标准:1年龄:≥90岁;2

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