全身麻醉联合椎管内麻醉对冠心病患者行骨科手术容量负荷及左室功能影响

目的 研究全身麻醉联合椎管内麻醉对冠心病患者行骨科手术容量负荷及左室功能影响情况。方法 选取骨科2016年12月～2019年12月80例冠心病骨科手术患者，将其随机分为观察组与对照组，每组40例患者，对照组患者手术之前给予全身麻醉，观察组患者给予全身麻醉联合椎管内麻醉，分析两组患者的情况。结果 对比两组患者不同时间点血流动力学指标发现，两组患者CVP在三个时间段无明显差异（P> 0.05）;SVV指标三个时间段无明显差异（P> 0.05）;SVI指标麻醉后观察组患者数值明显高于对照组（P <0.05）;CI指标三个时间段对比无明显差异（P> 0.05）;MAP指标在麻醉后出现显著差异（P <0.05）;HR指标手术1 h后出现显著差异，观察组数值高于对照组（P <0.05）。通过对比两组患者的心肌酶谱发现，在麻醉后和手术1 h后CK-MB数值低于对照组（P <0.05）；观察组患者在手术1 h后的LDH指标低于对照组（P <0.05）。对比两组患者的并发症情况，观察组并发症的发生率明显低于对照组（P> 0.05）。结论 全身麻醉联合...

Effects of general anesthesia combined with spinal anesthesia on volume load and left ventricular function of coronary heart disease orthopedic surgery

Objective To study the effect of general anesthesia combined with spinal canal anesthesia on the volume load and left ventricular function of coronary heart disease orthopedic surgery.Methods 80 patients with coronary heart disease orthopedic surgery from December 2016 to December 2019 in our orthopedics department were randomly divided into an observation group and a control group,with 40 patients in each group.Patients in the control group were given general anesthesia before surgery,patients in the group were given general anesthesia combined with spinal canal anesthesia,and the situation of patients in the two groups were analyzed.Results Comparing the hemodynamic indexes of the two groups of patients at different time points,it was found that the CVP of the two groups had no significant difference in three time periods(P>0.05);the SVV index had no significant difference in three time periods(P>0.05);The SVI values of the patients in the observation group after anesthesia were significantly higher than those of the control group(P<0.05);there was no significant difference in the comparison of the CI indicators in the three time periods(P>0.05);the MAP indicators showed a significant difference after anesthesia(P<0.05);the HR indicators There was a significant difference 1 hour after the operation,and the value of the observation group was higher than that of the control group(P<0.05).By comparing the myocardial enzyme spectrum of the two groups of patients,the CK-MB value was lower than the control group after anesthesia and 1 h after the operation(P<0.05);the LDH index of the observation group was lower than the control group 1 h after the surgery(P<0.05).Comparing the complications of the two groups of patients,the incidence of complications in the observation group was significantly lower than that in the control group(P>0.05).Conclusion General anesthesia combined with spinal canal anesthesia has a lower volume load on patients with coronary heart disease orthopedic surgery,hemodynamic indicators are also more stable,safe.