摘要
目的探讨老年髋部骨折手术采用腰-硬麻醉联合盐酸右美托咪定的术中及术后效果。方法选取2015年5月~2017年6月苏州第七人民医院收治的120例髋部骨折的老年患者,根据随机数字表法分为对照组和观察组,各60例,对照组采用腰-硬麻醉,观察组采用盐酸右美托咪定联合腰-硬麻醉。比较两组麻醉效果、血流动力学参数变化、血清B型尿钠肽(BNP)和D-二聚体(D-D)水平、不良反应。结果麻醉后两组疼痛视觉模拟量表评分(VAS)明显降低,Ramsay评分明显增加,观察组的这2项指标明显优于对照组(P <0.05);麻醉后两组血流动力学参数心率(HR)、平均动脉压(MAP)均显著降低,且观察组均显著低于对照组(P <0.05);术后血清BNP、D-D水平均显著增加,且观察组增加程度显著低于对照组(P <0.05);观察组不良反应显著低于对照组(P <0.05)。结论腰-硬麻醉与盐酸右美托咪定共同作用在老年髋部骨折手术中的麻醉、镇静效果显著,可有效调控血清BNP、D-D水平和血流动力学状态,从而降低不良反应发生率。
Objective To investigate the intraoperative and postoperative effects of combined spinal epidural anesthesia and dexmedetomidine hydrochloride on hip fracture in older patients.Methods 120 older patients with hip fracture were selected in Suzhou Seventh People’s Hospital from May 2015 to June 2017.The patients were divided into the control group and the observation group according to the random number table,60 cases in each group.The control group was treated with lumbar epidural anesthesia,and the observation group was treated with dexmedetomidine hydrochloride combined with lumbar epidural anesthesia.The anesthesia effect,hemodynamic parameters,levels of serum BNP and D-D,and adverse reactions were compared between the two groups.Results After anesthesia,the VAS score of the two groups decreased significantly,while Ramsay score increased significantly,and the scores of VAS and Ramsay in the observation group were significantly better than those in the control group(P < 0.05).After anesthesia,the heart rate(HR) and mean arterial pressure(MAP) in two groups were significantly reduced,and both of HR and MAP in the observation group were significantly lower than those in the control group(P < 0.05).After surgery,the levels of serum BNP and D-D were significantly increased,but the levels of BNP and D-D in the observation group were significantly lower than those in the control group(P < 0.05).The incidence of adverse reactions in the observation group was significantly lower than that in the control group(P < 0.05).Conclusion Combination of lumbar-hard anesthesia and dexmedetomidine hydrochloride exhibits remarkable anesthesia and sedation effects in older patients undergoing hip fracture surgery.It might effectively reduce the incidence of adverse reactions by regulating the levels of serum BNP and D-D,and hemodynamic status.
作者
艾雨超
徐丹
徐又佳
Ai Yuchao;Xu Dan;Xu Youjia(Department of Anesthesiology,the Seventh People’s Hospital of Suzhou,Suzhou 215151,China)
出处
《国际老年医学杂志》
2020年第2期92-95,共4页
International Journal of Geriatrics
基金
国家自然科学基金资助项目(81572179)。
关键词
髋部
腰-硬麻醉
右美托咪定
疗效
B型尿钠肽
D-二聚体
Hip
Spinal-epidural anesthesia
Dexmedetomidine
Effect
Type B natriuretic peptide
D-dimer
