杨娅

【摘要】 目的：探究老年人髋关节置换术中实施腰硬联合麻醉与全身麻醉的应用效果。方法：对笔者所在医院2018年2月-2019年2月实施髋关节置换术的60例老年患者的手术及麻醉情况进行回顾分析，实施全身麻醉的30例患者为对照组，实施腰硬联合麻醉的30例患者为研究组，对比两组各项麻醉指标，麻醉前后心率、血压测量结果，手术后并发症及疼痛情况。结果：研究组麻醉起效时间、阻滞完善时间均短于对照组，麻醉药物用药剂量少于对照组，麻醉后心率、收缩压、舒张压均优于对照组，术后并发症发生率及疼痛程度均低于对照组，差异均有统计学意义（P<0.05）。结论：老年人髋关节置换术中腰硬联合麻醉的麻醉效果明显优于全身麻醉，麻醉药物用量更少，且术后并发症发生率更低，麻醉安全性更高，值得推广应用。

【关键词】 全身麻醉; 腰硬联合麻醉; 老年人; 髋关节置换术

doi：10.14033/j.cnki.cfmr.2019.27.070 文献标识码 B 文章编号 1674-6805（2019）27-0-03

The Effect of General Anesthesia Combined with Lumbar Epidural Anesthesia in the Elderly Hip Joint Replacement/YANG Ya.//Chinese and Foreign Medical Research，2019，17（27）：162-164

【Abstract】 Objective：To explore the effect of general anesthesia combined with lumbar epidural anesthesia in the elderly hip joint replacement.Method：The operation and anesthesia of 60 elderly patients undergoing hip arthroplasty in our hospital from February 2018 to February 2019 were reviewed.30 patients with general anesthesia were the control group，30 patients with lumpy joint anesthesia were the study group.The anesthetic indexes，heart rate，blood pressure，postoperative complications and pain were compared between the two groups before and after anesthesia.Result：The onset time of anesthesia and the perfect time of block in the study group were shorter than those in the control group，the dosage of anesthetics was less than that in the control group，the heart rate，systolic blood pressure and diastolic blood pressure after anesthesia were better than those in the control group，the incidence and degree of postoperative complications were lower than those in the control group，the differences were statistically significant（P<0.05）.Conclusion：The anaesthesia effect of lumbar epidural anesthesia in hip arthroplasty is better than that of general anesthesia，the dosage of the anesthesia medicament is less，the postoperative complication rate is lower，the anesthesia safety is higher，and the anesthesia medicament is worthy of popularization and application.

【Key words】 General anesthesia; Lumbar epidural anesthesia; Elderly; Hip joint replacement

First-authors address：Xuanen County Peoples Hospital，Xuanen 445500，China

髖关节置换术是老年患者髋关节疾病治疗中常用的手术方式，患者手术中选取相适合的麻醉方式能够有效提升手术麻醉效果，降低对患者的伤害，提升老年患者对手术及麻醉的耐受性[1-2]。本研究对2018年2月-2019年2月在笔者所在医院实施髋关节置换术的60例老年患者的手术及麻醉情况进行回顾分析，探究老年人髋关节置换术实施中腰硬联合麻醉与全身麻醉的应用效果，具体如下。

1 资料与方法

1.1 一般资料

对2018年2月-2019年2月在笔者所在医院实施髋关节置换术的60例老年患者的手术及麻醉情况进行回顾分析。患者均符合髋关节置换术的手术要求，均无手术禁忌证、凝血功能异常及药物过敏情况。按照麻醉方式分为两组，对照组30例，男17例，女13例，年龄66～75岁，平均（70.1±1.2）岁;研究组30例，男16例，女14例，年龄67～77岁，平均（70.3±1.4）岁。……