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张小飞,施健▲.全身麻醉与椎管内麻醉对老年髋部骨折患者术后谵妄、疼痛和不良事件发生率的影响[J].中国医药科学,2024,14(7):136-138        基金项目:
全身麻醉与椎管内麻醉对老年髋部骨折患者术后谵妄、疼痛和不良事件发生率的影响
The effect of general anesthesia and intraspinal anesthesia on the incidence of postoperative delirium, pain, and adverse events in elderly patients with hip fractures
  
DOI:
中文关键词:  老年患者;髋部骨折;椎管内麻醉;谵妄;全身麻醉
英文关键词:Elderly patients; Hip fracture; Intraspinal anesthesia; Delirium; General anesthesia
作者单位
张小飞,施健▲ 江苏省南通市海门区人民医院,江苏南通 226100 
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中文摘要:
      [摘要] 目的 探讨全身麻醉与椎管内麻醉对老年髋部骨折患者术后谵妄、疼痛和不良事件发生率的影响。 方法 选取2018年1月至2022年12月江苏省南通市海门区人民医院骨科收治的80例65岁及以上髋部骨折手术患者。按随机数表法将其分为全身麻醉组(n=40)和椎管内麻醉组(n=40)。收集患者一般资料,并评估患者术后7 d内谵妄发生率,采用谵妄评定量表(DRS-98)评估患者谵妄得分,采用疼痛数字评价量表(NRS)评估患者术后7 d平均疼痛水平和不良事件发生率。 结果 全身麻醉组患者术后谵妄发生率高于椎管内麻醉组患者,差异有统计学意义(P < 0.05);全身麻醉组患者DRS-98评分高于椎管内麻醉组患者,差异有统计学意义(P < 0.05);两组患者术后疼痛评分、不良事件发生率比较,差异无统计学意义(P > 0.05)。 结论 与全身麻醉相比,椎管内麻醉可显著降低65岁及以上老年髋部骨折手术患者术后谵妄的发生率。
英文摘要:
      [Abstract] Objective To explore the effects of general anesthesia and intraspinal anesthesia on the incidence of postoperative delirium, pain, and adverse events in elderly patients with hip fractures in this study. Methods A total of 80 patients aged 65 and above who underwent hip fracture surgery at the Orthopedics Department of Nantong Haimen People’s Hospital, Jiangsu Province from January 2018 to December 2022 were selected. They were divided into a general anesthesia group (n=40) and an intraspinal anesthesia group (n=40) by random number method. The general patient information was collected and the incidence of delirium within 7 days after surgery was assessed. The delirium rating scale(DRS-98)was used to assess the patient’s delirium score, and the pain numerical rating scale(NRS) was used to evaluate the average pain level and incidence of adverse events within 7 days after surgery. Results The incidence of postoperative delirium in the general anesthesia group was higher than that of patients in intraspinal anesthesia group, with statistically significant difference (P < 0.05). The DRS-98 score of patients in the general anesthesia group was higher than that of patients in intraspinal anesthesia group, with statistically significant difference (P < 0.05). There was no statistically significant difference in postoperative pain scores and incidence of adverse events between the two groups of patients (P > 0.05). Conclusion Compared with general anesthesia, intraspinal anesthesia can significantly reduce the incidence of postoperative delirium in elderly patients aged 65 and above undergoing hip fracture surgery.
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