摘要
目的 观察腰硬联合麻醉与硬膜外麻醉对下肢骨折患者呼吸功能及血流动力学的影响。方法 选择安义县中医院2020年1月-2024年1月收治的下肢骨折患者50例为研究对象,利用随机数字表法将其分为对照组和研究组,每组25例。对照组行连续硬膜外麻醉,研究组应用腰硬联合麻醉。比较两组麻醉效果(感觉阻滞起效时间、持续时间、运动起效时间、最大运动阻滞时间、最大运动阻滞持续时间)、呼吸功能[呼吸频率(RR)、血氧饱和度(SpO_(2))、每分通气量(MV)]、血液动力学[平均动脉压(MAP)、舒张压(DBP)、收缩压(SBP)、心脏排血指数(CI)、心率(HR)、中心静脉压(CVP)]、不良反应发生率(头痛、恶心呕吐、低血压)。结果 研究组起效时间、持续时间、运动起效时间、最大运动阻滞时间均低于对照组,而最大运动阻滞持续时间大于对照组(P<0.05)。手术开始20 min,研究组SpO_(2)、MV水平高于对照组,而RR水平低于对照组(P<0.05)。研究组MAP水平低于对照组,而DBP、SBP、CI、HR、CVP水平高于对照组(P<0.05)。研究组不良反应发生率低于对照组(P<0.05)。结论 与硬膜外麻醉比较,腰硬联合麻醉在下肢骨折患者中的应用效果确切,能够获得更为理想的麻醉效果,对患者呼吸功能以及血流动力学的影响更小,且安全性较高,值得临床应用。
Objective To analyze and observe the effects of combined spinal-epidural anesthesia and epidural anesthesia on respiratory function and hemodynamics in patients with lower limb fracture.Methods Fifty patients with lower limb fractures admitted to Anyi County Hospital of Traditional Chinese Medicine from January 2020 to January 2024 were selected as the research objects.They were divided into control group and study group by random number table method,with 25 patients in each group.The control group received continuous epidural anesthesia,and the study group received combined spinal-epidural anesthesia.The anesthetic effect(sensory block onset time,duration,exercise onset time,maximum motor block time,maximum motor block duration),respiratory function[respiratory rate(RR),blood oxygen saturation(SpO_(2)),minute ventilation(MV)],hemodynamics[mean arterial pressure(MAP),diastolic blood pressure(DBP),systolic blood pressure(SBP),cardiac index(CI),heart rate(HR),central venous pressure(CVP)],incidence of adverse reactions(headache,nausea and vomiting,hypotension)were compared between the two groups.Results The onset time,duration,exercise onset time and maximum motor block time of the study group were lower than those of the control group,while the maximum motor block duration was greater than that of the control group(P<0.05).At 20 min after operation,the levels of SpO_(2) and MV in the study group were higher than those in the control group,while the level of RR was lower than that in the control group(P<0.05).The level of MAP in the study group was lower than that in the control group,while the levels of DBP,SBP,CI,HR and CVP were higher than those in the control group(P<0.05).The incidence of adverse reactions in the study group was lower than that in the control group(P<0.05).Conclusion Compared with epidural anesthesia,combined spinal-epidural anesthesia has a definite effect in patients with lower limb fractures.It can obtain a more ideal anesthetic effect,has less impact on patients′respiratory function and hemodynamics,and has higher safety.It is worthy of clinical application.
作者
谢来杰
XIE Laijie(Department of Anesthesiology,Anyi County Hospital of Traditional Chinese Medicine,Anyi 330500,Jiangxi,China)
出处
《医学信息》
2025年第20期81-84,89,共5页
Journal of Medical Information
关键词
腰硬联合麻醉
硬膜外麻醉
下肢骨折
呼吸功能
血流动力学
Combined spinal-epidural anesthesia
Epidural anesthesia
Lower limb fracture
Respiratory function
Hemodynamics
