【摘要】 目的研究全髋关节置换术中使用硬膜外低压麻醉的有效性和安全性。方法对993例全髋关节置换术采用硬膜外低压麻醉(平均动脉压维持在45~55 mm Hg)。处理股骨侧髓腔之前2~3 min,静脉给予肝素10～15 U/kg。结果本组平均手术时间83 min(35~268 min),平均失血量183 ml(50~1 400 ml)。术后随访3个月,共有13例发生血栓性疾病,占总数的1.3%,其中确诊为下肢深静脉血栓(DVT)的有10例,发生率为1.0%。无心血管疾病、硬膜外血肿发生。随访期间无死亡病例。结论全髋关节置换术中使用硬膜外低压麻醉安全,术中出血少,术后血栓发生率低,术后无相关的并发症。更多还原

【Abstract】 Objective To evaluate the safety and efficacy of hypotensive epidural anestheisa in total hip arthroplasty(THA) for VTE prophylaxis.Methods All of 993 consecutive patients undergoing THA were observed.The surgical operation was performed under hypotensive epidural anestheisa(mean arterial pressure between 45 ~55 mm Hg) through a posterolateral approach.Patients received one bolus of unfractionated intravenous heparin(10~15 U/kg),1~2 minutes before femoral canal preparation.Results The surgical operation was performed smoothly(83 min,range 35~256 min).The mean blood loss was 183 ml(50~1 400 ml).All patients were followed up at least 3 months postoperatively.No patients were lost to follow up.The incidence of clinical symptomatic VTE was 1.3%(13 of 933).The incidence of deep vein thrombosis was 1.0%(10 of 933).There were no cardiovascular diseases.No patients died and there was no epidural hematoma.Conclusion Based on this favorable experience and results,the hypotensive epidural anestheisa is safe and efficacious as thrombembolic prophylaxis.更多还原