摘要
目的:比较椎管内麻醉与全身麻醉下手术对下肢骨折老年患者下肢深静脉血栓(LDVT)发生率的影响。方法:选取2020年1月至2022年1月在永城市人民医院接受手术治疗的90例下肢骨折老年患者,依据随机数字表将全部患者均分为对照组(全身麻醉)与观察组(椎管内麻醉),各45例。比较两组患者手术情况、术后恢复情况、麻醉情况、术中生命体征、术后48 h运动功能状态,统计术后LDVT与麻醉并发症发生率。结果:观察组患者手术时间、术中出血量、术后床旁活动时间及住院时间均少于对照组,差异具有统计学意义(P<0.05);观察组患者麻醉生效时间、术后睁眼时间、语言陈述恢复时间、术中麻醉药物用量均少于对照组,差异具有统计学意义(P<0.05);观察组患者麻醉后10 min(T1)、术毕即刻(T2)时心率、平均动脉压均低于对照组,差异具有统计学意义(P<0.05);观察组患者术后48 h的运动功能分级优于对照组,差异具有统计学意义(Z=2.183,P<0.05);观察组患者术后LDVT发生率与麻醉不良反应总发生率均低于对照组,差异具有统计学意义(P<0.05)。结论:椎管内麻醉与全身麻醉相比,能够有效降低下肢骨折老年患者术后LDVT发生风险。
Objective To compare the effects of intraspinal anesthesia and general anesthesia on the incidence of lower extremity deep venous thrombosis(LDVT)in elderly patients with lower extremity fracture.Methods 90 elderly patients with lower extremity fracture who received surgical treatment in Yongcheng People's Hospital from January 2020 to January 2022 were selected and divided into a control group(general anesthesia)and an observation group(intraspinal anesthesia)according to random number table,45 cases in each group.Operation status,postoperative recovery status,anesthesia status,intraoperative vital signs,and motor function status 48 h after surgery were compared between the two groups,and the incidence of postoperative LDVT and anesthesia complications were analyzed.Results The operation time,intraoperative blood loss,postoperative time of bedside activity and hospital stay in the observation group were all less than those in a control group,and the differences were statistically significant(P<0.05).The effective time of anesthesia,postoperative eye opening time,speech statement recovery time and intraoperative anesthetic drug dosage in the observation group were all lower than those in a control group,and the differences were statistically significant(P<0.05).The heart rate and mean arterial pressure of the observation group at 10 min after anesthesia(T1),immediately after surgery(T2)were lower than those of the control group,and the differences were statistically significant(P<0.05).The grading of motor function 48 h after operation in the observation group was better than that in the control group,and the differences were statistically significant(Z=2.183,P<0.05).The incidence of postoperative LDVT and the total incidence of anesthesia adverse reactions in observation group were lower than those in control group,and the difference was statistically significant(P<0.05).Conclusion Compared with general anesthesia,intraspinal anesthesia can effectively reduce the risk of postoperative LDVT in elderly patients with lower extremity fracture.
作者
许哲
李灿
XU Zhe;LI Can(Yongcheng People's Hospital,Henan Yongcheng 476600)
出处
《深圳中西医结合杂志》
2024年第1期26-29,共4页
Shenzhen Journal of Integrated Traditional Chinese and Western Medicine
关键词
下肢骨折
椎管内麻醉
全身麻醉
下肢深静脉血栓
老年人
Lower extremity fracture
Intraspinal anesthesia
General anesthesia
Lower extremity deep venous thrombosis
Old people
