麻醉方式与老年人全髋关节置换后深静脉血栓发生率的分析

发布时间：2018-03-31 17:29

本文选题：深静脉血栓　切入点：全麻　出处：《吉林大学》2014年硕士论文

【摘要】：背景：在人们对生活质量的要求不断提高的今天，医学事业也发生了突飞猛进的进步和发展。很多创伤后、患有骨性关节炎或股骨头坏死的老年人选择了进行人工髋关节置换来恢复运动功能或者减轻疼痛。作为人工关节置换术后主要的并发症之一——下肢深静脉血栓(deep vein thrombosis, DVT)形成,不但影响患者的术后康复,还可引发致死的肺栓塞。近年来,随着人工关节置换术在我国广泛应用,麻醉方式的选择对深静脉血栓形成的影响越来越受到国内学者的关注。目的：比较老年人在全麻与腰硬联合麻醉下人工全膝关节置换术后深静脉血栓形成的发生率。方法：对2013年6月至2013年12月入院治疗的符合入选标准的104例老年患者进行比较分析。将人工全膝关节置换术老年患者随机分成2组。全麻组52例,腰硬联合麻醉组52例，利用彩色多普勒超声仪检查术前及术后4～8天、术后16天患者深静脉血栓的发生情况并进行分析。结果：共有20例发生下肢深静脉血栓：全麻组16例，发生率为30.80%（16/52），腰硬联合麻醉组4例，发生率为7.67%（4/52），深静脉血栓发生率方面，全麻组高于腰硬联合麻醉组，差异有统计学意义（P＜0.05）。结论：对于术后深静脉血栓这一并发症而言，相比较于全身麻醉方式，腰硬联合麻醉能够有效降低其发生率。
[Abstract]:Background:. Today, when people's demands on the quality of life are constantly improving, the medical profession has also made rapid progress and development. After a lot of trauma, Elderly patients with osteoarthritis or osteonecrosis of the femoral head choose artificial hip replacement to restore motor function or relieve pain. In recent years, with the extensive application of artificial joint replacement in China, it can also cause fatal pulmonary embolism. The influence of the choice of anesthesia on deep venous thrombosis has been paid more and more attention by domestic scholars. To compare the incidence of deep vein thrombosis in the elderly after total knee arthroplasty under general anesthesia and combined spinal-epidural anesthesia. 104 elderly patients who were admitted to hospital from June 2013 to December 2013 were compared and analyzed. The elderly patients undergoing total knee arthroplasty were randomly divided into two groups: general anesthesia group (n = 52) and combined spinal-epidural anesthesia group (n = 52). The incidence of deep venous thrombosis was analyzed 16 days after operation. Results:. There were 20 cases of deep venous thrombosis in lower extremity: 16 cases in general anesthesia group, 4 cases in combined spinal-epidural anesthesia group, 4 cases in combined spinal-epidural anesthesia group. The incidence of deep vein thrombosis was higher in general anesthesia group than in combined spinal-epidural anesthesia group (P < 0.05). Compared with general anesthesia, combined spinal-epidural anesthesia can effectively reduce the incidence of postoperative deep venous thrombosis.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R614;R687.4

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