不同的麻醉方式用于髋关节置换术的临床比较

发布时间：2018-02-15 15:59

本文关键词： 不同麻醉髋关节置换术临床比较　出处：《当代医学》2016年01期 　论文类型：期刊论文

【摘要】：目的探究在髋关节置换术中不同麻醉方式临床疗效情况,分析出3种不同的麻醉方式造成的对血流动力学安全性、稳定性的影响。方法收集需择期进行人工髋关节置换手术患者144例,随机分成3组:A组(进行持续硬膜外麻醉)、B组(进行腰麻复合硬膜外麻醉)和C组(进行全麻复合硬膜外麻醉),比较在诱导、切皮及骨水泥填充后几个时间点上患者体征变化和差异。结果 B组和C组的心率、中心静脉压和血压与A组差异明显,其中B组和C组在诱导、切皮和骨水泥填充后的心率分别为(75.93±6.05)、(77.14±7.65)、(77.98±9.15)和(73.68±5.88)、(73.12±6.35)、(77.40±6.25),中心静脉压分别为(7.17±3.25)(7.08±3.16)(8.92±3.15)和(7.12±3.48)(7.04±3.22)(8.37±3.37),均与A组比较差异有统计学意义(P0.05);B组和C组在各观察时间点比较,差异均无统计学意义。结论腰麻复合硬膜外麻醉与全麻复合硬膜外麻醉对血流动力学影响较小,可控性好。两者基本等效,均可以用于髋关节的置换手术。而此二者之间再做精细比较,如何在临床中进行选择,需在今后进一步研究证实。
[Abstract]:Objective to investigate the clinical efficacy of different anesthetic methods in hip arthroplasty and analyze the hemodynamic safety caused by three different anaesthesia methods. Methods 144 patients undergoing artificial hip replacement were collected. They were randomly divided into 3 groups: group A (continuous epidural anesthesia) and group C (general anesthesia combined with epidural anesthesia). Results the heart rate, central venous pressure and blood pressure in group B and C were significantly different from those in group A. The heart rate after skin incision and bone cement filling were 75.93 卤6.05 and 77.14 卤7.65, 77.98 卤9.15) and 73.68 卤5.88, 73.12 卤6.35, 77.40 卤6.25, respectively. The central venous pressure were 7.17 卤3.257.08 卤3.167.08 卤3.167.92 卤3.15) and 7.12 卤3.487.04 卤3.22g / 7.37 卤3.377, respectively, which were significantly different from those of group A (P 0.05) and group C (P 0.05). Conclusion Spinal anesthesia combined with epidural anesthesia and general anesthesia combined with epidural anesthesia have little effect on hemodynamics and good controllability. All of them can be used in hip arthroplasty, but the fine comparison between the two methods and how to select them in clinic need to be further studied and confirmed in the future.
【作者单位】：上饶市立医院;
【分类号】：R614

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