全身麻醉与全身麻醉复合硬膜外麻醉在关节置换术中应用效果对比.docVIP

全身麻醉与全身麻醉复合硬膜外麻醉在关节置换术中应用效果对比 　　[摘要]目的 探讨全身麻醉和全身麻醉复合硬膜外麻醉在关节置换术中的应用效果。方法 选择2015年3月～2016年9月在我院进行全髋关节置换术的74例患者作为研究对象，根据不同麻醉方式分为观察组（n=37）和对照组（n=37）。观察组行全身麻醉复合硬膜外麻醉，对照组行全身麻醉，比较两组患者的术中出血量、完全阻滞所需时间，统计术中不同时间点患者的血压、心率及术后患者下床活动时间以及两组术后认知功能的差异。结果 两组患者的术中出血量和术后下床活动时间比较，差异无统计学意义（P0.05）。观察组的完全阻滞时间短于对照组，且术中HR、MAP指标优于对照组（P0.05）。观察组术后6、12、24 h的MMSE评分高于对照组（P0.05）。结论 全身麻醉联合硬膜外麻醉对患者的血流动力学和认知功能的影响更小，具有较好的临床应用价值。 　　[关键词]全髋关节置换术；硬膜外麻醉；全身麻醉；临床效果 　　[中?D分类号] R614.2 [文献标识码] A [文章编号] 1674-4721（2017）12（b）-0107-03 　　[Abstract]Objective To investigate the application effect of general anesthesia and general anesthesia combined with epidural anesthesia on joint replacement.Methods 74 patients with total hip replacement in our hospital from March 2015 to September 2016 were selected as the subjects.The patients were divided into the observation group （n=37） and the control group （n=37） according to different anesthesia mode.The observation group was given general anesthesia combined with epidural anesthesia，and the control group was given general anesthesia.The amount of bleeding and the time needed for complete block were compared between the two groups.The blood pressure and heart rate at different time points were counted，the time of ambulation and the difference of postoperative cognitive function between the two groups were statistically analyzed.Results There was no significant difference between the two groups in the amount of bleeding and the time of ambulation after operation （P0.05）.The complete block time of the observation group was shorter than that of the control group，and the heart rate and MAP indexes in the operation were better than those in the control group （P0.05）.The MMSE score of the observation group at 6，12，24 h after operation was higher than that of the control group （P0.05）.Conclusion The effect of general anesthesia combined with epidural anesthesia on hemodynamics and cognitive function of patients is smaller，and has better clinical application value. 　　[Key wor