高龄全膝关节置换中全麻和硬膜外麻醉对凝血功能的影响

发布时间：2019-08-12 13:12

【摘要】：目的观察全身麻醉与硬膜外麻醉对全膝关节置换术高龄患者凝血功能与深静脉血栓并发症的影响。方法将80例行全膝关节置换术的高龄患者随机分为2组,全麻组40例选择全身麻醉,硬膜外组40例选择硬膜外麻醉,记录2组麻醉前(t1)、麻醉开始后30 min(t2)、手术结束时(t3)、术后1 d(t4)平均动脉压(MAP)、心率(HR)、血氧饱和度[Sp(O_2)],检测t1与t4时间点纤维蛋白原(FBG)水平、血小板计数(Plt)、活化部分凝血酶时间(APTT)及凝血酶原时间(PT)。结果 2组组内和组间各时间点Sp(O_2)比较差异均无统计学意义(P均0.05);2组t2时间点MAP均明显低于t1时间点(P均0.05),t3时间点MAP均明显高于t2时间点(P均0.05),t4时间点MAP均明显低于t3时间点(P均0.05),且全麻组t2~t4时间点MAP均明显高于硬膜外组(P均0.05);2组t2、t3时间点HR明显高于t1时间点(P均0.05),t4时间点HR均明显低于t3时间点(P均0.05),但2组间比较差异均无统计学意义(P均0.05)。全麻组t4时间点FBG明显高于t1时间点和硬膜外组(P均0.05),Plt、PT、APTT均明显低于t1时间点和硬膜外组(P均0.05)。全麻组深静脉血栓发生率明显高于硬膜外组(P0.05)。结论硬膜外麻醉对高龄全膝关节置换术患者凝血功能影响小于全身麻醉,可有效减少术后深静脉血栓的发生。
[Abstract]:Objective to observe the effects of general anesthesia and epidural anesthesia on coagulation function and complications of deep venous thrombosis in elderly patients undergoing total knee arthroplasty. Methods 80 elderly patients undergoing total knee arthroplasty were randomly divided into two groups. General anesthesia was selected in 40 patients in general anesthesia group and epidural anesthesia in 40 patients in epidural group. Before anesthesia (T1), 30 min (T2) after anesthesia, at the end of operation (T3), and 1 day after operation (T2), the mean arterial pressure (MAP), heart rate (HR), oxygen saturation [Sp (O 鈮，

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