全麻和腰硬联合麻醉用于髋关节置换术的临床效果探究陈辉郑亚成【摘要】目的：探究全麻和腰硬聯合麻醉用于髋关节置换术的临床效果。方法：选取2015年1月-2016年1月在笔者所在医院进行髋关节置换术的80例患者为研究对象，随机分为对照组和观察组，每组40例。对照组给予全麻处理，而观察组给予腰硬联合麻醉。统计两组患者的麻醉效果，手术时间、麻醉时间、感觉阻滞起效时间、运动阻滞起效时间，麻醉前后血流动力学参数的改变及发生不良反应的情况。结果：麻醉前，两组患者的收缩压，舒张压、心率比较，差异均无统计学意义（t=0.96、1.66、1.02，P>0.05）；麻醉后，观察组患者的收缩压，舒张压、心率均明显低于对照组，差异均有统计学意义（t=3.17、3.57、3.47，P0.05）；观察组患者感觉阻滞起效时间、运动阻滞起效时间短于对照组，差异均有统计学意义（t=9.89、5.80，P<0.05）。结论：全身麻醉和腰硬联合麻醉均可以维持良好的麻醉状态，但后者可缩短起效时间且对患者的血流动力学参数影响较小，降低并发症发生率，值得临床推广。【关键词】全身麻醉；腰硬联合麻醉；髋关节置换术；血流动力学参数doi：10.14033/j.cnki.cfmr.2018.18.008A1674-6805（2018）18-00-03ClinicalEffectofGeneralAnesthesiaandCombinedSpinalandEpiduralAnesthesiaforHipReplacement/CHENHui，ZHENGYacheng.//ChineseandForeignMedicalResearch，2018，16（18）：20-22【Abstract】Objective：Toinvestigatetheclinicaleffectsofgeneralanesthesiaandcombinedspinalandepiduralanesthesiaforhiparthroplasty.Method：Atotalof80patientsundergoinghiparthroplastyinourhospitalfromJanuary2015toJanuary2016wereselectedandrandomlydividedintothecontrolgroupandtheobservationgroup，40casesineachgroup.Thecontrolgroupwasgivengeneralanesthesiatreatment，whiletheobservationgroupwasgivencombinedspinalandepiduralanesthesia.Theanestheticeffectsofthetwogroupsofpatientswerecalculated，operationtime，anesthesiatime，onsettimeofsensoryblock，onsettimeofmotionblock，changeofhemodynamicparametersbeforeandafteranesthesia，andoccurrenceofadversereactionswerecompared.Result：Beforeanesthesia，therewerenosignificantdifferencesinsystolicbloodpressure，diastolicbloodpressure，andheartratebetweenthetwogroups（t=0.96，1.66，1.02，P>0.05）.Afteranaesthesia，thesystolicbloodpressure，diastolicbloodpressure，andheartratewerelowerintheobservationgroupthanthoseofthecontrolgroup，andthedifferenceswerestatisticallysignificant（t=3.17，3.57，3.47，P<0.05）.Therewerenosignificantdifferencesintheoperationtimeandanesthesiatimebetweenthetwogroups（t=1.09，0.06，P>0.05）.Theonsettimeofsensoryblockandtheonsettimeofmotionblockwereshorterintheobservationgroupthanthoseofthecontrolgroup，thedifferenceswerestatisticallysignificant（t=9.89，5.80，P<0.05）.Theincidenceofcomplicationsofveinthrombosisandpulmonaryinfectionintheobservationgroupweresignificantlylowerthanthoseinthecontrolgroup，andthedifferenceswerestatisticallysignificant（字2=5.00，3.91，P<0.05）.Conclusion：Bothgeneralanesthesiaandcombinedspinalandepiduralanesthesiacanmaintainagoodanestheticstatus，butthelattercansignificantlyshortentheonsettimeandhavelessinfluenceonhemodynamicparameters，reducetheincidenceofcomplications.Itisworthyofpromotioninclinical.【Keywords】Generalanesthesia；Combinedspinalandepiduralanesthesia；Hipreplacement；HemodynamicparametersFirst-authorsaddress：HanyangHospitalAffiliatedtoWuhanUniversityofScienceandTechnology，Wuhan430050，China目前國内外需要进行髋关节置换的患者人数逐年上升，其致病原因复杂多样，尚未在医学界得到一致认可。有研究表明，髋关节置换术可以有效地改善患者的不适症状...