老年妇科下腹部手术腰硬联合麻醉的临床观察

摘要

Objective To explore the clinical effect of combined spinal epidural anesthesia in elderly patients with lower abdominal surgery.Methods 134 elderly patients undergoing lower abdominal surgery in our hospital from January 2015 to March 2016 were selected and divided into control group and study group by the random number table method,67 cases in each group.Study group underwent combined spinal epidural anesthesia,while control group underwent epidural anesthesia.Observed the effect of anesthesia in two groups.Results There were statistically significant differences in anesthetic dosage,the onset time of anesthesia,and anesthesia plane fixed time between study group and control group [(4.7±2.1)ml vs.(11.7±4.4) ml,(1.7±1.1)min vs.(5.9±3.3)min,(4.8±2.7)min vs.(11.3±3.5)min;P＜0.05].After anesthesia,SBP,DBP,HR,and PErCO2 in both two groups decreased significantly,SPO2 increased significantly (P＜0.05).There were no statistically significant differences in hemodynamic parameters between two groups before and after anesthesia (P＞0.05).There was no statistically significant difference in the efficiency of anesthesia between study group and control group (95.5％ vs.94.0％,P＞0.05).There was no statistically significant difference in the incidence of adverse reactions between study group and control group (4.48％ vs.7.46％;x 2=1.008,P=0.604).Conclusion Combined spinal epidural anesthesia in the elderly patients with lower abdominal surgery has good clinical effect,without serious adverse reactions,with high safety of treatment,so it is worth to be popularized in clinical application.%目的 探究腰硬联合麻醉在老年人下腹部手术的临床效果.方法 选取2015年1月至2016年3月收治的134例行下腹部手术的老年患者,采用随机表法分为对照组与研究组,每组67例.研究组采用腰硬联合麻醉,对照组采用硬膜外麻醉,观察两组患者麻醉效果.结果 研究组患者麻醉用药量(4.7±2.1) ml、麻醉起效时间(1.7±1.1)min、麻醉平面固定时间(4.8±2.7) min,对照组患者麻醉用药量(11.7±4.4) ml、麻醉起效时间(5.9±3.3) min、麻醉平面固定时间(11.3±3.5) min,两组比较差异有统计学意义(P＜0.05);患者接受麻醉后SBP、DBP、HR及PETCO2均显著降低,而SP02则显著提升,麻醉前后比较差异有统计学意义(P＜0.05);两组患者麻醉前、后血流动力学参数组间比较差异无统计学意义(P＞0.05);研究组患者麻醉有效率为95.5％,对照组患者麻醉有效率为94.0％,两组比较差异无统计学意义(P＞0.05);对照组患者不良反应发生率为7.46％,研究组患者不良反应发生率为4.48％,两组比较差异无统计学意义(x2=1.008,P=0.604).结论 腰硬联合麻醉应用于老年人下腹部手术具有良好的临床效果,无严重不良反应发生,治疗安全性较高,值得在临床上推广应用.