摘要
目的探讨全身麻醉和蛛网膜下腔阻滞对髋关节置换术后患者早期预后的影响。方法回顾性分析2015年7月至2019年6月嘉兴市第二医院在全身麻醉或者蛛网膜下腔阻滞下接受髋关节置换患者261例,根据手术采取的麻醉方式分为2组:全身麻醉组(G组,n=179)和蛛网膜下腔阻滞组(S组,n=82)。采用卡钳法进行倾向值匹配后,76例患者的资料匹配成功,每组38例。收集患者术前一般资料和重要生化指标,比较两组患者麻醉时间、手术时间、术中出血量、输血量、住院天数、是否入住重症监护室、肺部感染、切口感染、尿路感染、深静脉血栓、非计划再次插管、院内死亡等信息。结果倾向值匹配后,G组和S组患者住院天数分别为(24±7)和(23±6)d,差异无统计学意义(t=0.691,P>0.05);术后入住重症监护室发生率分别为26.3%和7.9%,与G组比较,S组患者术后入住重症监护室率较低(χ2=4.547,P<0.05);两组患者其他各项指标差异均无统计学差异(均P>0.05)。结论全身麻醉和蛛网膜下腔阻滞对髋关节置换术后患者早期预后无明显影响,蛛网膜下腔阻滞可能减少患者术后入住重症监护室发生率。
Objective To investigate the effects of general anesthesia or spinal anesthesia on the early prognosis of patients after hip replacement.Methods A retrospective analysis of 261 patients who underwent hip arthroplasty under general anesthesia or spinal anesthesia from July 2015 to June 2019 was divided into two groups according to the anesthesia method adopted for surgery:General anesthesia group(group G,n=179)and Spinal anesthesia group(group S,n=82).Propensity score matching analysis with preset caliper width was used.76 pairs of patient data were successfully matched,with 38 cases in each group.General information and important biochemical indicators of patients before surgery were corrected.Comparison of anesthesia time,operation time,intraoperative bleeding volume,blood transfusion volume,length of hospital stay,whether to stay in intensive care unit,lung infection,incision infection,urinary tract infection,deep vein thrombosis,unplanned reintubation,death in the hospital and other information.Results After the propensity values were matched,the number of hospital stays in the group G and group S were(24±7)and(23±6)days,repectively,with no significant difference(t=0.691,P>0.05).The incidence of admission to the intensive care unit was 26.3%and 7.9%,compared with group G,the rate of patients admission to the intensive care unit was lower in the group S(χ2=4.547,P<0.05).There were no statistical differences of other indicators between the two groups(all P>0.05).Conclusion General anesthesia and spial anesthsesia have no significant difference in early prognosis of patients after hip replacement.Spinal anesthesia may associated with less intensive care unit stay after operation.
作者
周冬娜
裴大庆
周大春
Zhou Dongna;Pei Daqing;Zhou Dachun(Department of Anesthesiology,Sir Run Run Shaw Hospital,the Affiliated Hospital of Zhejiang University Medical School,Hangzhou 310016,China;Department of Anesthesiology,the Second Hospital of Jiaxing,Jiaxing 314000,China)
出处
《中华医学杂志》
CAS
CSCD
北大核心
2020年第19期1469-1473,共5页
National Medical Journal of China
关键词
麻醉
全身
麻醉
脊椎
置换
髋
预后
Anesthesia
general
Anesthesia
spinal
Replacement
hip
Prognosis
