王强 王青华 徐冰

[摘要] 目的 研究盐酸罗哌卡因联合硬膜外麻醉在老年髋关节手术患者中的具体应用以及对患者NIHSS评分的影响。方法 选取2016年6月～2018年1月我院60例将要进行髋关节手术的患者，并随机分成两组，A组患者引用盐酸罗哌卡因联合硬膜外麻醉，B组患者应用硬膜外麻醉。分别观察记录两组样本麻醉前、麻醉后10、20、30 min DBP、SBP、HR的变化特点，以及两组局麻药的用药剂量、药物起效时间、药物麻醉效等。 结果 与麻醉前相比，麻醉后两组患者的SBP及DBP指标均明显降低（P<0.05），但降低程度均在正常范围内；经统计发现A组的时间明显短于B组（P<0.05），而A组局麻的用药量也少于B组（P<0.05），A组的阻滞完全所需时间明显短于B组（P<0.05），A组应用麻黄素的患者例数明显多于B组（P<0.05）；麻醉前两组患者NIHSS比较，差异无统计学意义（P>0.05），麻醉后A组NIHSS低于B组，且组间比较，差异有统计学意义（P<0.05）。 结论 盐酸罗哌卡因联合硬膜外麻醉在老年髋关节手术患者中是一种比较安全有效的临床麻醉方法。

[关键词] 盐酸罗哌卡因；硬膜外麻醉；老年髋关节手术患者；NIHSS评分

[中图分类号] R614 [文献标识码] B [文章编号] 1673-9701（2018）30-0123-04

[Abstract] Objective To investigate the specific application of ropivacaine hydrochloride combined with epidural anesthesia in elderly patients with hip joint surgery and the effect on NIHSS scores. Methods A total of 60 patients who were going to undergo hip surgery in our hospital from June 2016 to January 2018 were randomly divided into two groups. The A group was given ropivacaine hydrochloride combined with epidural anesthesia. And the B group was treated with epidural anesthesia. The change characteristics of DBP， SBP and HR before anesthesia， and at 10， 20 and 30 minutes after anesthesia were recorded. The doses of local anesthetics， the onset time of the drugs and the anesthetic effect of the drugs between two groups were recorded. Results Compared with those before anesthesia， the SBP and DBP indexes of the two groups were significantly lower after anesthesia（P<0.05）， but the degree of reduction was within the normal range. It was found by statistics that the time of the A group was significantly shorter than that of the B group（P<0.05）， while the dose of local anesthesia in the A group was less than that of the B group（P<0.05）. The A group had a significantly shorter time required for the block than the B group（P<0.05）. The patients in A group were significantly more likely to have ephedrine than B group（P<0.05）. There was no significant difference in NIHSS between the two groups before anesthesia（P>0.05）. After anesthesia， the NIHSS in the A group was lower than that of the B group， and the difference between the two groups was statistically significant（P<0.05）. Conclusion Ropivacaine hydrochloride combined with epidural anesthesia is a safe and effective clinical anesthesia method in elderly patients with hip joint surgery.

[Key words] Ropivacaine hydrochloride； Epidural anesthesia； Elderly patients with hip surgery； NIHSS score

隨着人们生活水平的提高，物质生活也有了很大改善，人们对于身体的要求已不仅仅是健康，而是逐渐追求养生[1]。同时人们对疾病治疗的需求也随之增长，尤其在治病过程中药物的选择上也有了很大提高。老年人在当今社会更加受关注，尤其是随着物质生活水平的改善，子女们越来越重视老人的舒适度。病后接受治疗方法的类型是患者家属所较为关注的[2]。本文主要研究盐酸罗哌卡因联合硬膜外麻醉在老年髋关节手术患者中的具体应用以及对患者NIHSS评分的影响，选取两组患者进行对比分析，取得满意效果，现报道如下。

1 资料与方法

1.1 一般资料

选取2016年6月～2018年1月我院60例将行髋关节手术的患者，ASAⅡ～Ⅲ级，其中男43例，女17例，年龄65～87岁，随机分成两组，分别为盐酸罗哌卡因联合硬膜外麻醉组（A组）和硬膜外麻醉组（B组），每组30例。……