摘要
目的:观察腰-硬联合麻醉用于老年病人股骨上段手术的临床效果。方法:40例ASA%￣Ⅲ级老年择期手术病人,随机分为硬膜外麻醉组(EA组,n=20)和腰-硬联合麻醉组(CSEA组,n=20)。分别记录麻醉前(T0)、麻醉后15min(T1)、开刀时(T2)、使用骨水泥10min(T3)、术毕(T4)时平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO2)、肾素(PRA)及血管紧张素$(A$)的变化。记录痛觉阻滞平面达T10水平的时间。结果:两组病人在T0时MAP、HR、SpO2、PRA、AII值差异不显著(P>0.05)。同EA组相比,CSEA组麻醉起效时间明显缩短(P<0.05),两组MAP在T1、T2、T3各时点值均比T0值明显降低(P<0.05)。CSEA组PRA、AII在T1、T2、T3时值比T0值明显减少(P<0.05)。在T2、T3时PRA、AII值两组间比较差异显著(P<0.05)。HR及SpO2值在组内及组间比较差异均不显著(P>0.05)。结论:腰-硬联合麻醉用于老年人股骨上段手术,只要运用得当,不会对老年人产生不利的影响。
Objective To observe the clinical effect of combined spinal-epidural anesthesia （CSEA） on upper femoral fracture operation of old patients. Method 40 old patients （ASAⅠ～Ⅲ） scheduled for elective upper femoral fracture operation were randomly divided into the epidural anesthesia group （EA group, n=20） and the combined spinal-epidural anesthesia group （CSEA group, n= 20）. The changes of MAP, HIL, SpO2, PRA and All of pre-anesthesia （To）, 1Smin after anesthesia （T1）, immediately after skin incision （Tz）, 10min after used bone mineral cement （T3） and at the end of surgery （T4） were recorded respectively. The time of algesia block level reached T10 was recorded. Results There were no significant differences in MAP, FIR, SpO2, PRA and All between the two groups at To （P〉0.05）. The onset time of anesthesia in the CSEA group was obviously shorter than that in the EA group （P〈0.05）, and MAP at T1,T2 and T3 were significandy lower than those at T, in both groups （P〈0.05）. Plasmic PRA and All at T1, T2 and T3 were significantly lower than those at To in the CSEA group （P〈0.05）, and there were significant differences in PRA and All at T2 and T3 between the two groups （P〈0.05）. There were no sigmficant differences in HR and SpO2 between the two groups（P〉0.05）. Conclusion CSEA for upper femoral fracture operation has no adverse effects on old patients.
出处
《吉林医学》
CAS
2006年第9期1022-1023,共2页
Jilin Medical Journal
关键词
硬膜外麻醉
腰-硬联合麻醉
老年人
肾素
血管紧张素Ⅱ
Epidural anesthesia
Combined spinal-epidural anesthesia
Old patients
Renin
Angiotensin
