摘要
目的:观察硬膜外麻醉对髋关节置换术患者的临床疗效。方法:选取2020年5月-2021年11月在武汉中西医结合骨科医院住院治疗的髋关节置换术患者80例,根据麻醉方式的不同,分为观察组(n=40)和对照组(n=40)。对照组患者给予全身麻醉,观察组患者采用硬膜外麻醉,对比分析两种不同麻醉方式对患者围术期指标,包括活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、D-二聚体(D-D)、纤维蛋白原(FIB)、血清-淀粉样蛋白(Aβ)、神经元微管相关蛋白(Tau)等。结果:观察组患者恢复清醒时间[(8.13±2.42) min vs (11.26±3.34) min]、住院时间[(7.44±2.28)天vs (10.82±2.31)天]及血浆胆碱酯酶(CHE)恢复正常时间[(6.76±1.23)天vs (8.39±2.27)天]均显著缩短(均P<0.05)。麻醉后6 h,观察组患者PT[(12.47±0.92) s vs (13.35±0.84) s]、APTT[(29.56±1.49) s vs (33.15±1.79)s]降低,D-D[(1.75±0.47)μg/mL vs (1.33±0.45)μg/mL]及FIB[(5.13±1.05) g/mL vs (4.56±1.04) g/mL]均升高(均P<0.05)。术后1天,观察组患者Aβ[(532.26±119.85)μg/L vs (789.67±135.48)μg/L]、Tau[(76.83±8.68) ng/L vs (89.28±9.56) ng/L]及P-Tau[(82.23±9.31) pg/mL vs (91.44±9.72) pg/mL]均显著降低(均P<0.05)。结论:硬膜外麻醉可改善患者术后围术期相关指标,改善凝血功能、改善认知功能,临床疗效好,值得进一步推广应用。
Objective:To observe the clinical efficacy of epidural anesthesia in patients with hip arthroplasty.Methods:A total of 80 patients with hip arthroplasty hospitalized in Wuhan Orthopaedic Hospital of Integrated Traditional Chinese and Western Medicine from May 2020 to November 2021 were selected and divided into an observation group(n=40)and a control group(n=40)based on different anesthesia methods.The control group received general anesthesia,while the observation group received epidural anesthesia.The perioperative indicators of the two different anesthesia methods were comparatively analyzed,including activated partial thromboplastin time(APTT),prothrombin time(PT),D-dimer(D-D),fibrinogen(FIB),serum amyloid A protein(Aβ),neuronal microtubule-associated protein(Tau),etc.Results:The time to regain consciousness[(8.13±2.42)min vs(11.26±3.34)min],hospital stay[(7.44±2.28)days vs(10.82±2.31)days],and plasma cholinesterase(CHE)normalization time[(6.76±1.23)days vs(8.39±2.27)days]in the observation group were significantly shorter(all P<0.05).Six hours after anesthesia,the PT[(12.47±0.92)s vs(13.35±0.84)s]and APTT[(29.56±1.49)s vs(33.15±1.79)s]of the observation group decreased,while D-D[(1.75±0.47)μg/mL vs(1.33±0.45)μg/mL]and FIB[(5.13±1.05)g/mL vs(4.56±1.04)g/mL]increased(all P<0.05).One day after surgery,the Aβ[(532.26±119.85)g/L vs(789.67±135.48)g/L],Tau[(76.83±8.68)ng/L vs(89.28±9.56)ng/L],and P-Tau[(82.23±9.31)pg/mL vs(91.44±9.72)pg/mL]of the observation group were significantly lower(all P<0.05).Conclusion:Epidural anesthesia can improve perioperative-related indicators after surgery,improve coagulation function,improve cognitive function,and has good clinical efficacy,worthy of further promotion and application.
作者
董妍
夏林智
高振虎
Dong Yan;Xia Linzhi;Gao Zhenhu(Department of Orthopaedic Anesthesia,Affiliated Hospital of Wuhan Institute of Physical Education,Wuhan Orthopaedic Hospital of Integrated Traditional Chinese and Western Medicine,Wuhan 430079,China)
出处
《巴楚医学》
2024年第3期76-80,共5页
Bachu Medical Journal
基金
湖北省自然科学基金项目(No:2021CFB412)。
关键词
硬膜外麻醉
髋关节置换术
凝血功能
认知功能
epidural anesthesia
hip arthroplasty
coagulation function
cognitive function
作者简介
董妍,女,主治医师,主要从事骨科手术麻醉方向的研究。E-mail:dy20223322@163.com。
