单侧腰部麻醉和全身麻醉对老年患者髋关节置换术应激反应的影响

发布时间：2018-11-23 09:15

【摘要】：目的探讨单侧腰部麻醉和全身麻醉对老年患者髋关节置换术应激反应的影响。方法选择行单侧髋关节置换手术的老年患者60例,随机分为单侧腰部麻醉(单麻组)30例和全身麻醉(全麻组)30例,观察两组麻醉前15 min(T1)、手术完成(T2)、手术完成后24 h(T3)的呼吸循环系统指标、应激反应指标以及术中不良反应、手术后并发症发生情况。结果单麻组和全麻组在T1、T2、T3的平均动脉压、心率、血氧饱和度差异均无统计学意义(P均0.05);全麻组T2的血糖、血清皮质醇及儿茶酚胺均高于单麻组(P均0.05);单麻组、全麻组术中不良反应发发生情况分别为高血压2(6.67%)、8(26.67%)例,低血压0(0.00%)、4(13.33%)例,心动过缓2(6.67%)、9(30.00%)例,寒战0(0.00%)、1(3.33%)例;单麻组、全麻组术后并发症发生情况分别为头痛1(3.33%)、6(20.00%)例、、恶心呕吐0(0.00%)、5(16.67%)例、嗜睡3(10.00%)、10(33.33%)例、咽喉痛0(0.00%)、7(23.33%)例、肺部感染1(3.33%)、7(23.33%)例,单麻组术中不良反应发病率及术后并发症发生率均低于全麻组(P均0.05)。结论单侧腰部麻醉与全身麻醉相比,控制患者的应激反应水平方面更加理想,术中不良反应、术后并发症发生率更低。
[Abstract]:Objective to investigate the effects of unilateral lumbar anesthesia and general anesthesia on stress response of hip arthroplasty in elderly patients. Methods Sixty elderly patients undergoing unilateral hip replacement were randomly divided into unilateral lumbar anesthesia group (30 cases) and general anesthesia group (30 cases). 15 min before anesthesia (T1), the operation was completed (T2) in both groups. The indexes of respiratory and circulatory system, stress reaction, adverse reaction and complications after operation 24 hours after operation (T3). Results there was no significant difference in mean arterial pressure, heart rate and oxygen saturation between single anesthesia group and general anesthesia group (P 0.05). The levels of blood glucose, serum cortisol and catecholamine in general anesthesia group were higher than those in single anesthesia group (P 0.05). The incidence of adverse reactions in single anesthesia group and general anesthesia group were 2 (6.67%), 8 (26.67%), 0 (0.00%), 4 (13.33%) and 2 (6.67%) respectively. 9 (30.00%) cases, 0 (0.00%) shivers, 1 (3.33%) cases; The incidence of postoperative complications in single anesthesia group and general anesthesia group were 1 (3.33%), 6 (20.00%), 0 (0.00%), 5 (16.67%) and 3 (10.00%), respectively. 10 cases (33.33%), 0 (0.00%), 7 (23.33%), 1 (3.33%), 7 (23.33%), 1 (3.33%), 7 (23.33%) respectively. The incidence of adverse reactions and postoperative complications in single anesthesia group was lower than that in general anesthesia group (P 0.05). Conclusion compared with general anesthesia, unilateral lumbar anesthesia is more satisfactory in controlling the stress response level, adverse reaction during operation and the incidence of postoperative complications are lower.
【作者单位】：海南医学院第二附属医院;
【分类号】：R687.4

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