麻醉方式对全膝关节置换术后深静脉血栓发生率的影响

目的对全膝关节置换术前麻醉方式的研究,旨在探讨其对全膝关节术后患者深静脉血栓发生率的影响。方法选取自2010年11月至2011年11月在山东省临朐县人民医院接受全膝关节置换术的患者80例,采用随机数字表法将其随机的分为观察组和对照组,每组均为40例。对照组术前采取全麻方式进行麻醉处理,观察组术前采取硬膜外麻醉。观察并比较两组患者术后深静脉血栓的发生情况。结果两组患者在体质量指数、手术时间、麻醉时间、术中出血方面相似,差异无统计学意义（P〉0.05）;全麻组患者的血小板及纤维蛋白原含量、凝血酶原时间、凝血酶时间分别为（252.45±65.67）×109/L、（3.89±0.76）g/L、（11.58±1.72）s、（18.85±2.63）s,硬膜外麻醉组患者的血小板、纤维蛋白原、凝血酶原时间、凝血酶时间分别为（202.35±70.35）×109/L、（2.95±0.62）g/L、（14.65±1.33）s、（23.28±2.41）s,硬膜外麻醉组患者术后血小板及纤维蛋白原含量明显低于全麻组患者,而凝血酶原时间、凝血酶时间则较全麻组长;在血栓发生率方面,观察组为7.50%,低于全麻患者的血栓发生率40.00%,具有统计学意义（P〈0.05）。结论采取硬膜外麻醉能有效的降低全膝关节置换术后深静脉血栓的发生率,值得在临床上广泛应用。

Analysis on Impact of Anesthesia on the Incidence of Deep Vein Thrombosis after Full Knee Joint Arthroplasty

Objective To study on the anesthesia before the full knee joint arthroplasty with the aims of exploring the impact of anesthesia on the incidence of deep vein thrombosis of patients after full knee joint arthroplasty. Methods A total of 80 patients having received full knee joint arthroplasty in Linqu County People＇s Hospital from Nov. 2010 to Nov. 2011 were selected,and divided into observation group and control group at random with 40 patients in each group. The patients in control group were anesthetized with general anesthesia before the surgery,while the patients in observation group were anesthetized with epidural anesthesia before the surgery. The incidence of deep vein thrombosis of the two groups was observed and compared. Results Body mass index,operative time,anesthesia time,blood loss of the two groups were broadly similar（ P 0. 05）; platelet and fibrinogen,prothrombin time,thrombin time of the general anesthesia group were（ 252.45 ±65.67） ×109/L,（ 3. 89 ± 0. 76） g/L,（ 11. 58 ± 1. 72） s,（ 18. 85 ± 2. 63） s,of epidural anesthesia group were（ 202. 35 ± 70. 35） × 109/L,（ 2. 95 ± 0. 62） g/L,（ 14. 65 ± 1. 33） s,（ 23. 28 ± 2. 41） s, platelet and fibrinogen of epidural anesthesia group were significantly lower than the general anesthesia group,while prothrombin time,thrombin time were longer than the general anesthesia group; in the incidence of thrombosis,the observation group was 7. 50%,lower than 40. 00% of the general anesthesia group（ P 0. 05）. Conclusion Epidural anesthesia can reduce the incidence of deep vein thrombosis after full knee joint arthroplasty effectively,and is worthy of wide application in clinical.