全身麻醉复合硬膜外麻醉对下肢骨折手术患者的影响OA
Effect of General Anesthesia Combined with Epidural Anesthesia on Patients Undergoing Lower Limb Fracture Surgery
目的:探讨全身麻醉复合硬膜外麻醉对下肢骨折手术患者的影响.方法:回顾性选取2021年6月—2023年1月建瓯市立医院收治的 100 例下肢骨折手术患者.根据不同麻醉方法将其分为观察组和对照组,各 50 例.对照组给予全身麻醉,观察组在对照组基础上给予硬膜外麻醉.比较两组相关指标,术前及术后认知功能、氧化应激指标、凝血功能及并发症.结果:观察组麻醉药用量少于对照组,自主呼吸恢复时间、苏醒时间及语言恢复时间均早于对照组,差异有统计学意义(P<0.05).术后,观察组注意与集中、执行功能、命名、语言、视空间结构、抽象思维、延迟回忆、定向力评分均高于对照组,差异有统计学意义(P<0.05).术后,观察组纤维蛋白原(FIB)、纤溶酶原激活物抑制剂-1(PAI-1)均低于对照组;抗凝血酶-Ⅲ(AT-Ⅲ)高于对照组,差异有统计学意义(P<0.05).术后,观察组血糖(Glu)、皮质醇(Cor)、去甲肾上腺素(NE)及促肾上腺皮质激素(ACTH)水平均低于对照组,差异有统计学意义(P<0.05).观察组并发症发生率低于对照组,差异有统计学意义(P<0.05).结论:全身麻醉复合硬膜外麻醉可有效减轻下肢骨折患者机体应激反应,且全麻药用量少,苏醒快,对患者凝血功能、认知功能影响较小,可减少并发症发生率,安全可靠.
Objective:To explore the effect of general anesthesia combined with epidural anesthesia on patients undergoing lower limb fracture surgery.Method:A total of 100 patients with lower limb fracture treated in Jian'ou Municipal Hospital from June 2021 to January 2023 were retrospectively selected.According to different anesthesia methods,the patients were divided into observation group and control group,50 cases in each group.The control group received general anesthesia,and the observation group received epidural anesthesia on the basis of the control group.The related indicators,preoperative and postoperative cognitive function,oxidative stress index,coagulation function and complications were compared between the two groups.Result:The anesthetic dosage of the observation group was lower than that of the control group,and the recovery time of spontaneous respiration,recovery time and speech recovery time were earlier than those of the control group,the differences were statistically significant(P<0.05).After surgery,the scores of attention and concentration,executive function,naming,language,visuospatial structure,abstract thinking,delayed recall and orientation in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).After surgery,fibrinogen(FIB)and plasminogen activator inhibitor-1(PAI-1)in the observation group were lower than those in the control group;antithrombine-Ⅲ(AT-Ⅲ)were higher than those of control group,and the differences were statistically significant(P<0.05).After surgery,the levels of blood glucose(Glu),cortisol(Cor),norepinephrine(NE)and adrenocorticotropin(ACTH)in observation group were lower than those in control group,the differences were statistically significant(P<0.05).The incidence of complications in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion:General anesthesia combined with epidural anesthesia can effectively alleviate the stress response of patients with lower limb fractures.The dosage of general anesthesia is small,the recovery is fast,the impact on coagulation function and cognitive function is small,the incidence of complications is reduced,and it is safe and reliable.
张振球
建瓯市立医院 福建 建瓯 353100
下肢骨折手术全身麻醉硬膜外麻醉认知功能凝血功能应激反应
Surgery for lower limb fracturesGeneral anesthesiaEpidural anesthesiaCognitive functionCoagulation functionStress response
《中外医学研究》 2024 (016)
38-42 / 5
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