摘要
目的:探讨腰硬联合麻醉对妇科高龄手术患者的影响。方法:选取2020年2月-2021年8月在张掖市甘州区人民医院妇科行手术治疗的79例高龄患者作为研究对象,随机分为对照组(39例)和观察组(40例)。对照组采用持续硬膜外麻醉,观察组采用腰硬联合麻醉,对比两组神经阻滞起效、维持时间,并监测两组血流动力学指标、术后疼痛评分及炎症因子情况。结果:观察组运动神经、感觉神经阻滞的起效时间、维持时间均显著优于对照组(P<0.05)。观察组术后6、12 h的VAS评分显著优于对照组,差异有统计学意义(P<0.05)。观察组T_(1)、T_(2)、T_(3)、T_(4)、T_(5)的心率和平均动脉压均较T_(0)下降,与T_(0)比较差异无统计学意义(P>0.05),但均显著高于对照组(P<0.05)。术后6 h,观察组IL-6、CRP表达水平显著低于对照组(P<0.05)。结论:腰硬联合麻醉可有效减少高龄手术患者血流动力学指标波动性,且具有起效快、阻滞持续时间长、麻醉效果好等特征,并能减轻患者的炎症反应。
Objective:To investigate the effect of combined spinal and epidural anesthesia in elderly patients undergoing gynecological surgery.Method:A total of 79 elderly patients who underwent gynecological surgery in Zhangye Ganzhou District People’s Hospital from February 2020 to August 2021 were selected and they were randomly divided into control group(39 cases)and observation group(40 cases).Continuous epidural anesthesia was used in the control group and combined spinal and epidural anesthesia was used in the observation group.The onset,maintenance time of nerve block were compared between the two groups,and hemodynamic indexes,postoperative pain scores and inflammatory factors were monitored.Result:The onset time and maintenance time of motor nerve and sensory nerve block in the observation group were significantly better than those in the control group(P<0.05).The VAS scores of the observation group at 6 h and 12 h after operation were significantly better than those of the control group(P<0.05).The heart rate and mean arterial pressure of T_(1),T_(2),T_(3),T_(4) and T_(5) in the observation group were lower than those of T_(0),but there were no significant differences compared with T_(0)(P>0.05),but the indexes were significantly higher than those in the control group(P<0.05).The expression levels of IL-6 and CRP in the observation group were significantly lower than those in the control group at 6 h after operation(P<0.05).Conclusion:combined spinal and epidural anesthesia can effectively reduce the fluctuation of hemodynamic indexes in elderly patients,and has the characteristics of fast onset,long block duration and good anesthesia effect,so as to reduce the inflammatory reaction of patients.
作者
任振军
REN Zhenjun(Zhangye Ganzhou District People’s Hospital,Zhangye 734000,China)
出处
《中外医学研究》
2022年第25期173-176,共4页
CHINESE AND FOREIGN MEDICAL RESEARCH
关键词
腰硬联合麻醉
妇科
高龄
手术患者
血流动力学指标
神经阻滞
Combined spinal and epidural anesthesia
Gynaecology
Elderly
Surgical patients
Hemodynamic indexes
Nerve block
