陈箬娜

[摘要] 目的 研究腰-硬联合麻醉用于糖尿病下肢血管病变手术的麻醉效果。 方法 该次纳入2018年7月—2019年6月期间在该院进行手术治疗的80例糖尿病下肢血管病变患者展开研究，按照随机数字表法分为两组，对照组40例进行全身麻醉，观察组40例予以腰-硬联合麻醉。将两组的手术及麻醉情况、疼痛评分、血糖水平、麻醉满意度、不良反应发生情况进行比对。 结果 观察组糖尿病下肢血管病变患者的手术时间、麻醉起效时间、术后苏醒时间均短于对照组，而术后各个时间点的疼痛评分、血糖水平以及不良反应发生率均低于对照组，差异有统计学意义（P<0.05）。 结论 腰-硬联合麻醉应用在糖尿病下肢血管病变患者手术中的麻醉效果良好，有助于缓解术后疼痛感以及减少不良反应的发生。

[关键词] 糖尿病下肢血管病变;腰-硬联合麻醉;手术

[中图分类号] R587.2;R654.4          [文献标识码] A          [文章编号] 1672-4062（2020）01（b）-0041-03

[Abstract] Objective To study the anesthetic effect of combined lumbar-hard anesthesia for diabetic lower extremity vascular disease surgery. Methods Eighty patients with diabetic lower extremity vascular disease who underwent surgery in the hospital from July 2018 to June 2019 were enrolled. They were divided into two groups according to the random number table method， and 40 patients in the control group underwent general anesthesia. 40 patients in the observation group underwent combined lumbar-hard anesthesia. The surgery and anesthesia， pain score， blood glucose level， anesthesia satisfaction， and adverse reactions were compared between the two groups. Results The operation time， anesthesia onset time， and postoperative recovery time of patients with diabetic lower extremity vascular disease were shorter than those of the control group， and the pain score， blood glucose level， and adverse reaction rate at each time point were lower than those of the control group. The difference was statistically significant （P<0.05）. Conclusion The combination of lumbar-hard anesthesia is effective in the anesthesia of patients with diabetic lower extremity vascular disease， which can help relieve postoperative pain and reduce the incidence of adverse reactions.

[Key words] Diabetic lower extremity vascular disease; Lumbar-hard combined anesthesia; Surgery

糖尿病下肢血管病變是常见的糖尿病并发症[1-2]，主要表现为皮肤干燥、下肢麻木及疼痛、间歇跛行、下肢休息痛和足部坏疽[3]，会导致患者活动受限，严重者甚至因下肢溃疡坏死需要进行截肢处理，具有较高的致残率，故临床应积极预防和治疗糖尿病下肢血管病变。采用外科手术可进行保肢处理或截肢治疗，老年糖尿病患者的自身基础状况差且机体免疫力减退，对麻醉的耐受度不高，多种因素会影响麻醉效果，增加围手术期风险事件发生风险[4]，不利于手术疗效及安全，因此在术中应选择合理的麻醉药物，以促进手术顺利进行以及提高手术安全性。该文对腰-硬联合麻醉在该病患者术中的效果进行探讨，分析2018年7月—2019年6月间在该院进行治疗的80例糖尿病下肢血管病变患者的临床资料，现报道如下。……