胡晓露

【摘 要】目的：探究全麻联合硬膜外麻醉对ERAS指导下的髋关节置换术患者术后机能、自我认知及不良反应的影响。方法：盲抽在我院进行手术治疗的82例髋关节置换术患者分为试验组与对照组（41例/组），对照组接受快速康复外科（ERAS）指导下的全麻手术，试验组接受ERAS指导下的硬膜外麻醉联合全麻的手术。结果：试验组的麻醉时间、输液量均明显低于对照组，且试验组的平均动脉压显著优于对照组（P<0.05）；试验组的术后恢复呼吸时间、苏醒时间、拔管时间和住院天数均明显低于对照组（P<0.05）；两组患者麻醉前VAS评分对比差异不明显（P>0.05），但在术后的苏醒期和术后3d中，试验组VAS评分均明显低于对照组（P<0.05）；试验组患者术后不良反应发生率低于对照组（P<0.05）。结论：硬膜外麻醉联合全身麻醉在ERAS指导下的髋关节置换术患者中具有良好的效果。

【关键词】髋关节置换术；硬膜外麻醉；全麻；ERAS

Effects of general anesthesia combined with epidural anesthesia on postoperative function， self-cognition and adverse reactions of patients undergoing hip replacement surgery under the guidance of ERAS

Hu Xiaolu

The Affiliated Hospital of Xuzhou Medical University， Xuzhou， Jiangsu， 221000， China

【Abstract】Objective：To explore the effects of general anesthesia combined with epidural anesthesia on postoperative function， selfcognition and adverse reactions of patients undergoing hip replacement under the guidance of ERAS. Methods：Blindly drawn 82 patients undergoing hip replacement surgery in our hospital were divided into experimental group and control group （41 cases/group）. The control group received general anesthesia under the guidance of Rapid Rehabilitation Surgery （ERAS）， and the experimental group received ERAS Surgery under the guidance of epidural anesthesia combined with general anesthesia. Results：The anesthesia time and the amount of fluid in the test group were significantly lower than those of the control group， and the average arterial pressure of the test group was significantly better than that of the control group（P<0.05）， the postoperative respiration time， recovery time， extubation time and hospitalization of the test group The number of days was significantly lower than that of the control group （P<0.05）， there was no significant difference in the VAS scores of the two groups before anesthesia（P>0.05）， but the VAS scores of the experimental group were significantly lower in the postoperative recovery period and 3 days after surgery In the control group （P<0.05）， the incidence of adverse reactions in the experimental group was lower than that in the control group（P<0.05）.Conclusion Epidural anesthesia combined with general anesthesia has a good effect in hip replacement patients under the guidance of ERAS.

【Key？Words】hip replacement； epidural anesthesia； general anesthesia； ERAS

髖关节置换术是人工关节置换术的一种，可缓解患者疼痛，缩短患者卧床时间，帮助患者恢复关节功能等，因此髋关节置换术是目前矫正关节畸形、恢复关节运动功能的常用治疗方式[1]。手术恢复效果往往与麻醉方式具有明显联系，临床研究发现，经单纯全身麻醉的手术患者术后身体机能和自我认知能力恢复较慢，且全麻不能阻断低级中枢传导，导致心律增快和血压升高等。硬膜外麻醉可与全身麻醉互补，具备镇痛且避免心律、血压波动等效果[2]。本研究通过观察全身麻醉联合硬膜外麻醉对ERAS指导下的髋关节置换术患者术后的机能和不良反应的影响，总结如下。……