针刺辅助麻醉在老年髋关节置换术中的应用研究
|
摘要
目的探讨针刺辅助麻醉在老年髋关节置换术中的应用研究。方法选取2018年6月～2019年2月于本院骨科择期行老年髋关节置换术患者70例,随机分为两组,对照组予瑞芬太尼输注麻醉,实验组加用针刺麻醉。观察两组拔管时间、呼之睁眼时间、复苏室停留时间、Prince-Henry评分、Steward苏醒评分、WAIS评分、不良反应发生率。结果与对照组相比,拔管时间、呼之睁眼时间、复苏室停留时间缩短,Prince-Henry评分、Steward苏醒评分较高(P<0.05)。与对照组术后1 d相比,实验组术后1 d WAIS评分较高,差异具有统计学意义(P<0.05)。结论老年髋关节置换术患者予以针刺麻醉联合瑞芬太尼麻醉,可以缩短术后清醒时间,提高术后认知功能。
Objective To investigate the application of acupuncture-assisted anesthesia in elderly hip joint replacement. Methods A total of 70 elderly patients with hip joint replacement who underwent elective surgery in the department of orthopedics in our hospital from June 2018 to February 2019 were selected and randomly divided into two groups. The control group was given anesthesia with remifentanil infusion. The experimental group was further given anesthesia with acupuncture. The time of extubation, the duration of eye opening, the length of stay in recovery room,the Prince-Henry score, the Steward recovery score, the WAIS score, and the incidence of adverse reactions were observed in both groups. Results Compared with the control group, the time of extubation, the duration of eye opening,the length of stay in the recovery room were shorter in the experimental group, and the Prince-Henry score and Steward recovery score were higher in the experimental group(P<0.05). Compared with the control group one day after the surgery, the WAIS score was higher in the experimental group one day after the surgery, and the difference was statistically significant(P<0.05). Conclusion It is suggested that acupuncture anesthesia combined with remifentanil anesthesia be used for the elderly patients undergoing hip joint replacement, which can shorten postoperative waking time and improve postoperative cognitive function.
Objective To investigate the application of acupuncture-assisted anesthesia in elderly hip joint replacement. Methods A total of 70 elderly patients with hip joint replacement who underwent elective surgery in the department of orthopedics in our hospital from June 2018 to February 2019 were selected and randomly divided into two groups. The control group was given anesthesia with remifentanil infusion. The experimental group was further given anesthesia with acupuncture. The time of extubation, the duration of eye opening, the length of stay in recovery room,the Prince-Henry score, the Steward recovery score, the WAIS score, and the incidence of adverse reactions were observed in both groups. Results Compared with the control group, the time of extubation, the duration of eye opening,the length of stay in the recovery room were shorter in the experimental group, and the Prince-Henry score and Steward recovery score were higher in the experimental group(P<0.05). Compared with the control group one day after the surgery, the WAIS score was higher in the experimental group one day after the surgery, and the difference was statistically significant(P<0.05). Conclusion It is suggested that acupuncture anesthesia combined with remifentanil anesthesia be used for the elderly patients undergoing hip joint replacement, which can shorten postoperative waking time and improve postoperative cognitive function.
引文
[1]Fang L.Alzheimer's Disease Increases the Incidence of Hospitalization Due to Fall-related Bone Fracture in Elderly Chinese[J].International Journal of Gerontology,2016,10(4):227-231.
[2]Loyson T,Van CT,Sch觟ffski P,et al.Incidence of osteonecrosis of the jaw in patients with bone metastases treated sequentially with bisphosphonates and denosumab[J].Acta Clinica Belgica,2017,73(2):1.
[3]李玲.优质护理对老年脑梗死患者生活质量、护理满意度及预后的改善作用[J].实用临床护理学电子杂志,2017,2(10):100-101.
[4]郄晓娟,郑文婧,董江龙,等.老年患者髋关节置换术后认知功能障碍的危险因素分析[J].广东医学,2016,37(10):1488-1491.
[5]陆立岚,崔枫岚,李雪.人工全髋关节置换手术配合标准操作流程的建立与应用[J].实用临床医药杂志,2018,22(14):84-86.
[6]张琳,马民玉,阚全程.舒芬太尼复合丙帕他莫用于上腹部手术患者术后静脉镇痛的效果及安全性[J].郑州大学学报(医学版),2009,44(2):377-379.
[7]Kotwani MB,Malde AD.Comparison of maintenance,emergence and recovery characteristics of sevoflurane and desflurane in pediatric ambulatory surgery[J].Journal of Anaesthesiology Clinical Pharmacology,2017,33(4):503-508.
[8]戴晓阳,龚耀先.韦氏成人智力量表中国修订本与原量表(WAIS和WAIS-R)因素分析的比较研究[J].心理学报,1987,(1):70-78.
[9]杨礼庆,马超,杜帅.人工全膝关节置换术围手术期疼痛管理现状[J].中国矫形外科杂志,2017,25(3):247-250.
[10]Sanz-Reig J,Marín JS,Martínez JF,et al.Prognostic factors and predictive model for in-hospital mortality following hip fractures in the elderly[J].Chinese Journal of Traumatology,2018,21(3):163-169.
[11]Maharlouei N,Atefi S,Namazi H,et al.The incidence of hip fracture in Shiraz,Iran:a promising rate comparing to previous studies[J].Osteoporos Int,2017,28(9):1989-1993.
[12]王力伟,李学良,郝晓,等.瑞芬太尼复合丙泊酚对高血压脑出血手术患者血流动力学及苏醒时间的影响观察[J].河北医药,2015,37(14):2143-2145.
[13]梁燕.丙泊酚复合瑞芬太尼靶控输注对腹腔镜胆囊切除术老年患者血流动力学的影响[J].中国医学创新,2016,13(25):133-136.
[14]雷鹏飞,高杉,薛然荣,等.瑞芬太尼诱发大鼠切口痛觉过敏时脊髓CXCL10及其配体CXCR3的表达变化及意义[J].华中科技大学学报(医学版),2016,45(3):306-310.
[15]李继峰.针药结合麻醉术下手术治疗混合痔疗效观察[J].中国伤残医学,2016,24(15):50-51.
[2]Loyson T,Van CT,Sch觟ffski P,et al.Incidence of osteonecrosis of the jaw in patients with bone metastases treated sequentially with bisphosphonates and denosumab[J].Acta Clinica Belgica,2017,73(2):1.
[3]李玲.优质护理对老年脑梗死患者生活质量、护理满意度及预后的改善作用[J].实用临床护理学电子杂志,2017,2(10):100-101.
[4]郄晓娟,郑文婧,董江龙,等.老年患者髋关节置换术后认知功能障碍的危险因素分析[J].广东医学,2016,37(10):1488-1491.
[5]陆立岚,崔枫岚,李雪.人工全髋关节置换手术配合标准操作流程的建立与应用[J].实用临床医药杂志,2018,22(14):84-86.
[6]张琳,马民玉,阚全程.舒芬太尼复合丙帕他莫用于上腹部手术患者术后静脉镇痛的效果及安全性[J].郑州大学学报(医学版),2009,44(2):377-379.
[7]Kotwani MB,Malde AD.Comparison of maintenance,emergence and recovery characteristics of sevoflurane and desflurane in pediatric ambulatory surgery[J].Journal of Anaesthesiology Clinical Pharmacology,2017,33(4):503-508.
[8]戴晓阳,龚耀先.韦氏成人智力量表中国修订本与原量表(WAIS和WAIS-R)因素分析的比较研究[J].心理学报,1987,(1):70-78.
[9]杨礼庆,马超,杜帅.人工全膝关节置换术围手术期疼痛管理现状[J].中国矫形外科杂志,2017,25(3):247-250.
[10]Sanz-Reig J,Marín JS,Martínez JF,et al.Prognostic factors and predictive model for in-hospital mortality following hip fractures in the elderly[J].Chinese Journal of Traumatology,2018,21(3):163-169.
[11]Maharlouei N,Atefi S,Namazi H,et al.The incidence of hip fracture in Shiraz,Iran:a promising rate comparing to previous studies[J].Osteoporos Int,2017,28(9):1989-1993.
[12]王力伟,李学良,郝晓,等.瑞芬太尼复合丙泊酚对高血压脑出血手术患者血流动力学及苏醒时间的影响观察[J].河北医药,2015,37(14):2143-2145.
[13]梁燕.丙泊酚复合瑞芬太尼靶控输注对腹腔镜胆囊切除术老年患者血流动力学的影响[J].中国医学创新,2016,13(25):133-136.
[14]雷鹏飞,高杉,薛然荣,等.瑞芬太尼诱发大鼠切口痛觉过敏时脊髓CXCL10及其配体CXCR3的表达变化及意义[J].华中科技大学学报(医学版),2016,45(3):306-310.
[15]李继峰.针药结合麻醉术下手术治疗混合痔疗效观察[J].中国伤残医学,2016,24(15):50-51.