老年股骨颈骨折患者行全髋关节置换术后麻醉恢复期躁动的影响因素

目的:探讨老年股骨颈骨折患者行全髋关节置换术后麻醉恢复期发生躁动的影响因素。方法:回顾性分析我院老年股骨颈骨折行全麻全髋关节置换术患者46例,根据躁动情况分为躁动组和平静组,每组各23例。比较两组患者术前白蛋白、血红蛋白、白细胞、总胆红素、谷草转氨酶、丙氨酸转氨酶水平;术中失血量、尿量、麻醉时间、心率、舒张压、收缩压水平;躁动组患者各种不良刺激的比例。结果:术前,与平静组相比,躁动组白蛋白、血红蛋白水平较低(P0.05),白细胞计数、总胆红素水平较高(P0.05),谷草转氨酶、丙氨酸转氨酶差异无统计学意义(P0.05);术中,与平静组相比,躁动组尿量水平较低(P0.05),失血量、心率、麻醉时间、收缩压水平较高(P0.05),舒张压差异无统计学意义(P0.05);躁动组不良刺激影响中尿管刺激占比例最高,疼痛刺激其次。结论:老年股骨颈骨折患者行全髋关节置换术后麻醉恢复期躁动与术前白蛋白、血红蛋白、白细胞计数水平,术中失血量、尿量、麻醉时间、心率、收缩压水平,尿管刺激、疼痛刺激、气管导管刺激及体位不当刺激有关。

Analysis of the Influencing factors of Restless in Anesthesia Recovery Periodof Elderly Patients with Femoral Neck Fracture after Total Hip Arthroplasty

Objective:To investigate the influencing factors of restless in anesthesia recovery period of elderly patients withfemoral neck fracture after total hip arthroplast.Methods:A total of 46cases of elderly patients with femoral neck fracture after total hiparthroplasty from our hospital were collected and divided into the restless group and calm group with 23 cases in each group.Thepreoperative albumin, hemoglobin, white blood cells, total bilirubin, aspartate aminotransferase, alanine aminotransferase levels,intraoperative blood loss volume, urine volume, anesthesia time, heart rate and diastolic pressure, systolic pressure levels were comparedbetween two groups; the proportion of adverse stimuli of restless group were analyzed.Results:Before operation, compared with thecalm group, the albumin and hemoglobin levels of the restless group were lower (P < 0.05), white blood cells and total bilirubin levelswere higher (P<0.05), aspartate aminotransferase and alanine aminotransferase had no statistical significance (P> 0.05); intraoperation,compared with the calm group, the urine volume level of restless group was lower (P<0.05), blood loss, heart rate, anesthesia time andsystolic pressure levels were higher (P <0.05), diastolic pressure difference was no statistical significance (P>0.05); the adverse stimuli ofthe restless group, the catheter stimulation accounted for the highest proportion, pain stimulation was followed.Conclusion:The elderlypatients with femoral neck fracture after total hip arthroplasty of anesthesia recovery periodrestless was related to the preoperative,intraoperative indexes, catheter stimulation, pain stimulation, tracheal tube stimulation and postural stimulation.