【摘要】 目的观察下肢关节置换术对术中血气及术后SpO₂的影响。方法 52例全身麻醉下行下肢关节置换术的患者中,膝关节置换术29例（A组）,髋关节置换术23例（B组）。观察两组麻醉前后、A组术中松止血带前后以及B组假体植入前后动脉血气的变化,观察两组手术前后SpO₂的变化。结果 A组PaO₂由麻醉前的（80.2±8.4） mmHg降至麻醉后的（69.7±9.8） mmHg（P<0.01）;B组PaO₂由麻醉前的（84.4±9.9） mmHg降至麻醉后的（74.0±7.9） mmHg（P<0.01）。A组松止血带前后5 min内PaO₂由（461.0±47.2） mmHg降至（379.7±50.4） mmHg（P<0.01）;B组假体植入前后PaO₂由（489.6±57.0） mmHg降至（403.6±60.1） mmHg（P<0.01）。术后1 d两组SpO₂水平均低于术前（P<0.01）,B组术后3 d恢复至术前水平（P>0.05）,而A组术后6 d仍低于术前（P<0.05）。结论骨科下肢手术明显影响患者肺氧合功能,尤其是膝关节置换术的影响更明显。更多还原

【Abstract】 Objective To observe the effect of lower limb arthroplasty on arterial gas during operation and oxygen saturation after operation.Methods Lower limb arthroplasty under general anesthesia was performed in 52 patients,of whom 29 cases accepted knee arthroplasty（group A） and 23 cases underwent hip arthroplasty（group B）.The change of arterial blood gas analysis in two groups was observed before and after anesthesia,before and at 5 minutes after tourniquet deflation intraoperatively in group A,and before and after prosthesis placement in group B.In addition,SpO₂ was monitored perioperatively in two groups.Results PaO₂ was decreased from（80.2±8.4） mmHg before anesthesia to（69.7±9.8） mmHg after anesthesia in group A（P<0.01）,which was decreased from（84.4±9.9） mmHg to（74.0±7.9） mmHg in group B（P<0.01）.PaO₂ was decreased from（461.0±47.2） mmHg before tourniquet deflation to（379.7±50.4） mmHg at 5 minutes after tourniquet deflation intraoperatively in group A（P<0.01）,which was decreased from（489.6±57.0） mmHg before prosthesis placement to（403.6±60.1） mmHg after prosthesis placement in group B（P<0.01）.SpO₂ was lower on the 1^st day after operation than that before operation in two groups（P<0.01）,which returned to the preoperative level on the 3^rd day after operation in group B（P>0.05） and was still lower than preoperative level on the 6^th day after operation in group A（P<0.05）.Conclusion The orthopedic lower limb surgery impairs the patients’ pulmonary oxygenation,which is even worse in knee arthroplasty.更多还原