全麻和腰硬联合麻醉用于髋关节置换术的临床效果观察

目的探讨全麻联合腰硬联合麻醉用于髋关节置换术的应用效果及术后不良反应。方法将我院2011年12月~2012年2月收治的60例髋关节置换术患者分为观察组和对照组,每组各30例。对照组采用气管插管全麻,观察组采用腰硬联合麻醉,比较两组的麻醉效果、血液动力学变化及不良反应。结果观察组在诱导后、插管后即刻、切皮时、拔气管导管时的心率、收缩压、舒张压均显著小于对照组（均P〈0.05）。且观察组的麻醉用药剂量、患者的感觉阻滞起效、阻滞完全时间以及麻醉的效果均显著优于对照组（均P〈0.05）。观察组的术后镇痛显著优于对照组,不良反应的发生率显著低于对照组（P〈0.05）。结论腰硬联合麻醉用于髋关节置换术效果较好,患者血液动力学稳定,不良反应少,值得临床推广。

Clinical effect observation of general anesthesia combined with spinal and epidural anesthesia used in total hip arthroplasty

Objective To investigate the application effect and postoperative adverse reaction of general anesthesia combined with combined spinal and epidural anesthesia in total hip arthroplasty.Methods 60 patients treated with total hip arthroplasty in our hospital from December 2011 to February 2012 were completely randomLy divided into observation group and control group.The control group patients used endotracheal intubation anesthesia,and the observation group patients used combined spinal and epidural anesthesia.Then the anesthetic effect,hemodynamic change and adverse reaction in two groups were compared.Results The heart rate,systolic blood pressure and diastolic pressure of observation group patients at the point of post-induction,immediately post-intubation,cut skin,extubation were significantly less than that of control group（all P 0.05）.And the anesthesia dosage,onset time of sensory block,completely block time and anesthetic effect of observation group patients were significantly superior to that of control group（all P 0.05）.The postoperative analgesia in observation group was significantly better than that of control group,and the incidence of adverse reactions was significantly lower than that of control group（P 0.05）.Conclusion Combined spinal and epidural anesthesia is effective for total hip arthroplasty.And patients have stable hemodynamics and less adverse reactions,so it is worth to spread in clinical application.