老年下肢骨科手术患者采用腰硬联合麻醉和全身静脉麻醉的效果及安全性分析

李彩霞，吴泽龙

（陕西省靖边县人民医院，陕西 榆林，718500）

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摘要：

目的 比较老年下肢骨科手术患者采用腰硬联合麻醉和全身静脉麻醉的效果及安全性。方法 选取我院2015年6月至 2016年9月收治的96例老年患者为研究对象，将其随机分为观察组（n=48）与对照组（n=48）。对照组实施全身静脉麻醉，观 察组实施腰硬联合麻醉，对比两组患者麻醉镇痛效果及血流动力学指标情况。结果 观察组麻醉镇痛优良率为93.75%，明显高于对照组的77.08%，差异具有统计学意义（P<0.05）；麻醉前，两组患者的SBP、HR、DBP 比较，差异不显著（P>0.05）；麻醉 后30 min，两组患者的HR、DBP及SBP明显降低，且观察组低于对照组，差异具有统计学意义（P<0.05）。结论 腰硬联合麻醉 用于老年下肢骨科手术患者麻醉镇痛效果更好，且能稳定患者生命体征，改善血流动力学水平，值得在临床上推广使用。

关键词：老年患者；骨科手术；腰硬联合麻醉；全身静脉麻醉

中图分类号：R614文献标志码：A文章编号：2096-1413(2017)32-0081-02

Efficacy and safety of combined spinal-epidural anesthesia and general intravenous anesthesia in elderly patients undergoing orthopedic surgery of lower limbs
LI Cai-xia, WU Ze-long
(Jingbian County People``s Hospital, Yulin 718500, China)

ABSTRACT: Objective To compare the effect and safety of combined spinal-epidural anesthesia and general intravenous anesthesia in elderly patients undergoing orthopedic surgery of lower limbs. Methods A total of 96 elderly patients in our hospital from June 2015 to September 2016 were randomly divided into observation group (n=48) and control group (n=48). The control group was given general intravenous anesthesia, while the observation group was given combined spinal -epidural anesthesia. The analgesic effects and hemodynamics levels were compared between the two groups. Results The excellent rate of anesthesia analgesia in the observation group was 93.75%, which was significantly higher than 77.08% of the control group, the difference was statistically significant (P<0.05). Before anesthesia, the SBP, HR and DBP of the two groups were not significantly different (P>0.05 ); at 30 minutes after anesthesia, the HR, DBP and SBP of the two groups significantly decreased, and those in the observation group were lower than the control group, the differences were statistically significant (P <0.05). Conclusion Combined spinal -epidural anesthesia in elderly patients undergoing orthopedic surgery of lower limbs has remarkable effect, it can stabilize the vital signs of patients and improve the hemodynamics level, which is worth to be promoted in clinic.
KEYWORDS: elderly patients; orthopedic surgery; combined spinal-epidural anesthesia; general intravenous anesthesia

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