椎管内麻醉与全身麻醉用于高龄骨科手术患者的临床效果比较

发布时间：2018-04-03 19:50

本文选题：老年　切入点：骨科　出处：《临床合理用药杂志》2016年11期

【摘要】：目的比较椎管内麻醉与全身麻醉应用于高龄骨科手术患者的临床效果。方法选取2013年11月-2015年12月医院行骨科手术的老年患者99例,随机分为研究组50例和对照组49例。研究组行椎管内麻醉,对照组行全身麻醉,比较2组的麻醉效果。结果研究组麻醉药用量明显少于对照组,其语言陈述时间短于对照组,差异有统计学意义(P0.05)。术前2组高龄患者MMSE评分比较差异无统计学意义(P0.05);术后1h、3h,研究组MMSE评分明显高于对照组,差异有统计学意义(P0.05)。研究组术后神经错乱发生率10.00%明显低于对照组的40.82%,其术后认知障碍发生率为6.00%明显低于对照组的26.53%,差异有统计学意义(P0.05)。结论高龄骨科手术中,椎管内麻醉的效果优于全身麻醉,其麻醉药用量较少,语言陈述时间短,术后MMSE评分高,神经错乱与认知障碍发生率低,有助于高龄患者的手术进展,值得临床推广应用。
[Abstract]:Objective to compare the clinical effects of intraspinal anesthesia and general anesthesia in elderly patients undergoing orthopaedic surgery.Methods 99 elderly patients undergoing orthopedic surgery from November 2013 to December 2015 were randomly divided into study group (n = 50) and control group (n = 49).The study group was treated with intraspinal anesthesia and the control group with general anesthesia.Results the dosage of anesthetic in the study group was significantly less than that in the control group, and the time of language statement in the study group was shorter than that in the control group, and the difference was statistically significant (P 0.05).There was no significant difference in MMSE score between the two groups before operation (P 0.05), but the MMSE score in the study group was significantly higher than that in the control group at 1 hour or 3 h after operation (P 0.05).The incidence of postoperative neurosis in the study group was significantly lower than that in the control group (10.00% vs 40.82%), and the incidence of postoperative cognitive disorder was 6.00% lower than that in the control group (26.53%). The difference was statistically significant (P 0.05).Conclusion in the elderly orthopedic surgery, the effect of intraspinal anesthesia is better than that of general anesthesia, with less anesthetic dosage, shorter speech statement time, higher MMSE score, lower incidence of neurologic disorder and cognitive impairment, which is helpful to the surgical progress of the elderly patients.It is worth popularizing and applying in clinic.
【作者单位】：贵州医科大学附属医院;
【分类号】：R614

【参考文献】