不同自体输血技术与异体输血在人工全膝关节置换术中的分析比较

目的 分析比较人工膝关节置换术中的自体输血及同种异体输血疗效及术前预存自体输血与术中回收式自体输血的应用效果.方法 将267例人工全膝关节置换术分为术前储存式自体血输血组(Ⅰ组,n=85例)、术中回收式自体输血组(Ⅱ组,n=101例)、输同种异体血(Ⅲ组,n=81例),对3个组的输血情况和2个自体输血组的血液检测指标作分析比较并作统计学分析.结果 Ⅰ、Ⅱ组分别有71.9％ (61/85)和65.7％ (66/101)无需输异体血顺利度过了围手术期,而Ⅲ组仅为28.6％ (23/81)(P＜0.05);2个自体输血组与Ⅲ组的用血量(mL/人)分别为500±200、400±200、1 000±200(P＜0.05);Ⅰ组采血前、后血液指标无明显差异,Ⅱ组术后1d的RBC、Hb、HCT均明显低于术前(P＜0.05),但术后1周恢复正常,术中回收血经光镜观察细胞形态正常,无明显碎片,细菌培养阴性.结论 自体输血可避免大多数人工全膝关节置换术中输注异体血带来的潜在风险,极大节约血源.     

关节置换术后自体血液回收的临床应用观察

目的 分析髋膝关节置换术后自体血液回收的临床应用情况,为血液保护技术推广提供循证输血学证据.方法 111例髋膝关节置换术患者按手术当天至术后7d内输血方式分为3组,自体组仅输自体血,异体组仅输异体血,混合组输自体血和异体血；自体血主要为术后回收非洗涤式自体全血.比较3组总失血量、自体血及术日至术后7d内异体血输注量、术前、术后Hb及变化.结果 自体组与混合组总失血量均较高于异体组,但自体组与混合组无差异；自体组与混合组自体血输注量无差异；异体组与混合组术日RBC输注量和7 d RBC输注量无差异;3组内术前与术后1d、7d Hb值配对比较有显著性差异；自体组术前Hb值最高,异体组最低；术后1 dHb改变3组无差异；但自体组术后7d Hb改变值高于异体组,混合组与其他2组无明显差异.结论 结合患者术前基本情况以及术中、术后失血,可灵活应用术后自体血液回收以减少甚至避免异体输血；临床医师接受该技术的同时,也应注重输血指证的把握与控制.     

ANH联合氨甲环酸对全膝关节置换术失血量和输血量的影响

目的观察急性等容血液稀释(ANH)联合氨甲环酸对全膝关节置换术失血量和输血量的影响。方法将98例全膝关节置换术患者通过电脑随机法分为ANH组和联合组,每组49例。ANH组行术中ANH,联合组采用ANH和氨甲环酸联合应用。观察两组患者自体输血前后血红蛋白(Hb)、红细胞压积(Hct)、血小板计数(PLT)变化及术前、术后凝血酶原时间(PT)、部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)、D-二聚体变化,记录患者失血量、异体血输注量、尿量和术后引流量。结果联合组自体输血后Hb、Hct平均水平明显高于ANH组,差异有统计学意义(P0.05);联合组术后D-二聚体水平明显高于ANH组,差异有统计学意义(P0.05);联合组失血量、异体血输注量及术后1d引流量明显少于ANH组,差异有统计学意义(P0.05)。结论自体输血与氨甲环酸联合应用可明显减少全膝关节置换术中失血量和异体血输注量,有一定的临床推广价值。     

ANH与AHH在异位妊娠手术中的应用效果比较

目的比较急性等容血液稀释(ANH)与急性高容血液稀释(AHH)在异位妊娠手术中的应用效果。方法将96例异位妊娠患者随机分为ANH组、AHH组和对照组,每组32例。ANH组和AHH组在麻醉诱导后、手术前分别行ANH和A H H,对照组术前不进行急性稀释性采血,麻醉诱导后、手术前输注复方乳酸钠注射液。比较A N H组与A H H组急性血液稀释前后血红蛋白(Hb)、红细胞压积(Hct)、碱剩余(BE)、血乳酸(LAC)等血气指标的变化水平;比较ANH组与AHH组各时点平均动脉压(MAP)、心脏指数(CI)、每搏量变异率(SVV)等血流动力学指标;比较3组术后Hb、Hct、血小板(PLT)水平及异体输血情况。结果 (1)ANH组与AHH组血液稀释前后Hb、Hct及BE、LAC等血气指标的差异无统计学意义(P0.05);(2)ANH组自体血回输前后MAP及CI明显高于AHH组(P0.05),SVV明显低于AHH组(P0.05);(3)ANH组术后2hHb、Hct、PLT水平明显高于AHH组及对照组(P0.05),异体输血例数及异体红细胞输注量明显少于AHH组及对照组(P0.05)。AHH组异体血输注例数及异体红细胞输注量明显少于对照组(P0.05)。结论 ANH可有效减少异位妊娠术中红细胞的丢失,减少异体血输注,对血流动力学影响较小,输血安全性能良好,具有一定的临床应用价值。     

心脏瓣膜置换术患者应用改良贮存式自体输血和异体输血的效果比较

目的 对比改良贮存式自体输血和异体输血对心脏外科瓣膜置换术患者手术及术后恢复的影响,确定改良贮存式自体输血采血法在心脏外科手术中应用的效果.方法 选取2013年1～5月本院行心脏瓣膜置换术的择期手术患者200例,其中使用改良贮存式自体输血采血法进行术前自体备血的患者100例,年龄21～73岁,心功能分级Ⅱ～Ⅲ级,采血前平均Hb为（147.34＆#177;12.69） g/L,Hct为（43.41土3.72）％;使用异体血术前备血的患者100例,年龄18～71岁,心功能分级Ⅱ～Ⅲ级,术前平均Hb为（133.93＆#177;25.94） g/L,Hct为（38.24＆#177;9.41）％,对比两组患者在围术期各项指标的差异.结果 100例改良贮存式自体输血组使用血液总量319U,100例输注异体血组使用血液655U,两者相比,自体输血组手术血液使用总量、平均异体红细胞量、平均异体血浆量均明显降低（P＜0.05）.自体输血组采血后血红蛋白浓度、红细胞压积轻度降低,但在正常范围内.术后1d血红蛋白浓度及红细胞压积均明显高于异体输血组患者,差异具有统计学意义（P＜0.05）.出院前血红蛋白浓度、红细胞压积两组患者比较差异不明显;自体输血组患者术后到出院的平均时间为（6.58＆#177;1.9）d,异体输血组患者为（10.01＆#177;3.87）d,差异有统计学意义（P＜0.05）.使用改良贮存式自体输血的患者术后未发生感染,而异体输血组患者术后感染率为3％.同时自体输血组患者的住院成本明显降低（P＜0.05）.结论 改良贮存式自体输血采血法,较异体输血法对红细胞破坏少,血液输注量少,患者术后各项指标恢复快,感染率低,经济实用,可广泛应用于心脏外科瓣膜病等择期手术.     

自体血引流回输在人工关节置换术患者中的应用

目的探讨自体血引流回输在人工关节置换术患者中的应用效果。方法选择我院2018年6—12月同一治疗组初次行人工髋关节、膝关节置换术患者79例,将单纯输注异体血患者49例作为对照组,自体血引流回输患者30例作为观察组,比较两组患者手术前后血红蛋白水平、红细胞计数及术中出血量、异体血输血量、术后引流量与输血反应和发热率。结果观察组患者异体输血量少于对照组(P 0. 05);两组患者术中出血量、手术前后血红蛋白水平与红细胞计数、术后引流量比较差异均无统计学意义(P 0. 05);两组患者均未发生输血反应、发热反应。结论自体血回输及异体血输注均可达到满意的临床治疗效果。自体血引流回输患者的异体输血量明显低于单纯输注异体血的患者。目前国内血源紧张,自体血引流回输可有效缓解临床用血紧张情况,值得临床推广使用。     

脊柱外科术中输血治疗的回顾性分析

目的了解脊柱外科手术中输血情况及特点,以便节约血源,更好地开展合理输血。方法回顾性分析2011年12月至2012年11月期间我院498例脊柱后路植骨内固定术患者自体血应用情况及异体血输注情况,分为两组,术中应用自体血回输组（z组）248例和输异体血而未应用自体血回输（C组）250例。比较两组患者术前和术后的Hb浓度、红细胞压积（Hct）值、血小板（PLT）计数、凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、纤维蛋白原（Fib）浓度,记录两组患者的术中出血量,术中自体血回输和异体血输入量,术后引流量及术后并发症的发生情况。结果两组患者的一般资料及血常规、血凝常规化验结果无统计学差异（P〉0．05）。出血量和术后引流量Z组大于C组,差异有统计学意义（P〈0．05）。Z组248例自体血回输患者回输洗涤红细胞103484ml（平均Hct=50％,相当于库血Hct=40％约129355ml）,即每例患者回输自体血417ml,相当于节约库血522ml。Z组人均输少白红细胞（2．7±1．1）U;术后Hb（96．8±15．5）g／L。C组人均输注少白红细胞（2．9±1．3）U,与Z组比较无统计学差异（P〉0．05）;术后Hb（106．3±15．1）g／L,与Z组比较差异有统计学意义（P〈0．05）。所有患者术后均无严重并发症发生。结论出血量较大的脊柱后路植骨内固定术患者应用自体血回输可节约异体红细胞,且不增加并发症风险,但应注意纠正凝血功能。     

贮存式自体输血在髋关节置换术中的应用

目的探讨贮存式自体输血和异体输血对髋关节置换术患者手术及术后恢复的临床应用效果。方法将台州医院2013—2014年181例髋关节置换术患者分为自体血组(n=100)和异体血组(n=81),对2组患者的手术前后各项血液指标进行分析。结果术后3 d自体血组的血小板分布宽度明显低于异体血组(P0.05),其他血常规、凝血指标指标均无明显差异(P0.05);异体血组术后3 d丙氨酸氨基转移酶、天冬氨酸氨基转移酶明显高于自体血组(P0.05);异体血组术后1 d前白蛋白明显低于自体血组(P0.05),术后3 d总蛋白、白蛋白明显低于自体血组(P0.05);异体血组腺苷脱氨酶术后1 d、术后3 d明显高于自体血组(P0.05);自体血组的出血量、输血量明显低于异体血组,差异有统计学意义(P0.05)。结论贮存式自体输血是1种安全、有效的输血方式,可避免大多数关节置换术中输注异体血带来的潜在危险,又节约了血液资源,值得在临床推广。     

术中自体血回输在脊柱手术中的应用及对围术期血液指标的影响

目的探讨术中自体血回输（IAT）在脊柱外科大手术中的作用,以及对围手术期血常规和凝血功能指标的影响。方法选取49例接受术中自体血回输的患者为IAT纽,以同期49例常规异体输血手术患者为库血组．比较两组输血量、术后血红蛋白（Hb）、红细胞压积（HCT）、血小板（PLT）、凝血酶原时间（PT）、纤维蛋白原（Fbg）X．术后并发症等情况。结果IAT组中红细胞回收率为65．60％。术后IAT组49例患者中仅15例加用异体库血输注．回输自体血占总输血量的76．62％,平均异体输血量明显小于库血组,差异有统计学意义（t=69．70,P〈0．05）。IAT组术后第1天Hb、HCT相对术前均有不同程度减少,PT显著延长,差异均有统计学意义（t分别=5．55、5．09、4．51。P均〈0．05）,IAT组术后第3天Hb、PT与术前比较,差异均有统计学意义（t分别=7。14、5．09,P均〈0．05）;但库血组Hb、PT在术后第3天与术前比较,差异均无统计学意义（t分别=0．77、0．84,P均〉0．05）;IAT组Hb、HCT和胛在术后第7天内亦能较快恢复,与术前比较,差异均无统计学意义（t分别=1.43、0．98、1.12。P均〉0．05）。术后IAT组较库血组并发症少。差异有统计学意义（χ2=4．66,P〈0．05）。结论IAT技术可达到较高红细胞回收率,明显减少异体库2b．用量;术后并发症少,血液和凝血相关指标较快恢复,可安全应用于脊柱外科手术。     

急性等容血液稀释联合回收式自体输血在异位妊娠手术患者中的应用研究

目的探讨急性等容血液稀释(ANH)联合回收式自体输血在异位妊娠手术患者中的应用价值。方法选择2015年3月至2016年4月本院收治的异位妊娠大出血手术患者85例。46例患者接受ANH联合自体血回输治疗(观察组),39例患者接受异体血输注治疗(对照组)。收集两组患者年龄、体质量指数(BMI)、术前血红蛋白(Hb)水平、腹痛时间、停经时间等基线数据。记录两组患者术中失血量及输血量。检测两组患者术前及术后白细胞(WBC)、C-反应蛋白(CRP)及红细胞沉降率(ESR)水平。结果两组患者年龄、BMI、术前Hb水平、腹痛时间、停经时间等基线资料比较差异无统计学意义(P0.05)。观察组患者术前预存血量(559±128)mL、回收血量(510±103)mL,库存血输注例数和输注量明显少于对照组(P0.05)。两组患者术前CRP、ESR及WBC水平比较差异无统计学意义(P0.05),术后第1、3、5天CRP、ESR水平及术后第1、3天WBC水平均高于术前(P0.05)。观察组术后第1、3、5天CRP、ESR水平均明显低于对照组(P0.05)。结论与输注异体血相比,ANH联合回收式自体输血可降低异位妊娠患者术后炎性反应程度,具有一定的临床应用价值。     

急性等容血液稀释联合控制性低中心静脉压对肝叶切除术患者凝血功能和术中出血量的影响

目的探讨急性等容血液稀释(ANH)联合控制性低中心静脉压(LCVP)对肝叶切除术患者凝血功能和术中出血量的影响。方法 60名择期在全麻下行肝叶切除术患者随机分为对照组(Ⅰ组)、LCVP组(Ⅱ组)和ANH联合LCVP组(Ⅲ组)3组,每组20例。Ⅰ组常规处理不行ANH或LCVP;Ⅱ组开腹后至肝实质离断期间实施LCVP,维持CVP 2～5 cmH2O;Ⅲ组麻醉诱导后行ANH,其他处理同Ⅱ组。观察3组患者不同时点凝血功能指标的变化,记录术中出血量、异体输血量及异体输血例数。结果与Ⅰ组比较,Ⅱ组和Ⅲ组出血量、异体输血量和异体输血例数明显减少(P0.05);与Ⅱ组比较,Ⅲ组异体输血量和异体输血例数明显减少(P0.05)。3组各时点凝血功能指标均在正常范围内。结论 ANH与LCVP联合应用于肝叶切除术,能明显减少术中出血和异体输血,且对凝血功能无明显不利影响。     

Influence of a 6-week arm exercise program on walking ability and health status after hip arthroplasty: a 1-year follow-up pilot study

The influence of an upper-limb interval-training program after total hip arthroplasty (THA) in elderly patients was studied during a 1 yr follow-up on health status and walking ability. After surgery, 14 patients were randomly assigned to the control group that started a 6 wk general rehabilitation program or the training group that combined it with an interval exercise program on an arm ergometer. A Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index was completed 1 mo before and 2 mo and 1 yr after surgery. A 6 min walking test was performed at 2 mo and 1 yr after surgery. The training group covered a significantly longer distance than the control group in the 6 min walk test and obtained significantly lower WOMAC scores both at 2 mo and 1 yr after surgery. However, both groups significantly improved in WOMAC and in their performance during the survey. Endurance-type upper-body aerobic training in a rehabilitation program might be important after THA.     

急性等容量血液稀释在骨关节手术中应用

目的：观察急性等容量血液稀释（ANH）在骨关节手术中的节约用血效果。方法：择期行骨科大手术患者18例,随机分成两组：C组（n=9）为对照组,在手术前不进行血液稀释;ANH组（n=9）为研究组,在麻醉后手术前进行等容量血液稀释。患者麻醉诱导后手术开始前进行ANH。放血量（V）=患者预计血容量（EBV）×[放血前血细胞压积（H0）-允许最低血细胞压积（Hf）]/H0和Hf的均值（Hctav）,本研究中允许最低血细胞压积为25%。连续监测血压、心率和心律、脉搏氧饱和度,记录术中尿量,出血量、输血补液量,术毕、术后24h及72h分别查血红蛋白（Hb）、血细胞压积（Hct）、血小板计数（Bpc）。结果：ANH组平均采血量为（883±204）mL,稀释后Hct平均为（27.67±4.86）%,对照组输异体血的量明显高于ANH组,而输液量明显低于ANH组。两组手术结束时及术后24h、72h的Hb、Hct都较术前有明显降低。ANH组血液稀释后Bpc有减少趋势,而对照组同一时点无明显改变。结论：骨科大手术中失血较多,ANH是节约用血的有效方法。     

Cardioprotective effects of acute normovolemic hemodilution in patients with severe aortic stenosis undergoing valve replacement

BACKGROUND: After acute normovolemic hemodilution (ANH), improvement of the rheologic conditions may contribute to optimize tissue oxygen delivery and attenuate ischemia-reperfusion injuries. It was hypothesized that ANH would confer additional cardioprotection in patients with ventricular hypertrophy undergoing open heart surgery. STUDY DESIGN AND METHODS: This study was a randomized controlled trial. Forty patients scheduled for elective aortic valve replacement were randomly assigned to a control group (standard care) or an ANH group (target hematocrit level of 28%). All patients were managed with standard myocardial preservation techniques (cold blood cardioplegia, anesthetic preconditioning). The outcome measures included the release of myocardial enzymes, perioperative hemodynamic changes, the need for pharmacologic cardiovascular support, and cardiac complications. RESULTS: In the ANH group, the postoperative release of troponin I (mean peak plasma concentrations, 1.7 ng/mL; 95% confidence interval, 1.4-2.1 ng/mL) and myocardial fraction of creatine kinase (22 U/L; range, 18-24 U/L) was significantly lower than in the control group (3.6 [range, 3.0-4.2] ng/mL and 45 [range, 39-51] U/L, respectively). In addition, requirement for inotropic support was significantly lower and fewer hemodiluted patients presented adverse cardiac events. After ANH, there was a significant decrease in heart rate (-11 +/- 6%) and rate-pressure product (-16 +/- 8%) until the aortic cross-clamping time and, at the end of surgery, the circulating levels of erythropoietin (EPO) were higher than in control patients (13.6 +/- 4.2 mUI/mL vs. 7.3 +/- 2.4 mUI/mL; p < 0.05). CONCLUSIONS: Besides conventional cardiac preservation techniques, preoperative ANH further attenuates myocardial injuries. Optimization of preischemic myocardial oxygen delivery and/or consumption and the postconditioning effects of endogenous EPO are potential mechanisms for ANH-induced cardioprotection.     

Evidence for myocardial defects under extreme acute normovolemic hemodilution with hydroxyethyl starch and lactated ringer's solution

Acute normovolemic hemodilution (ANH) has been proposed to avoid the risks of allogenic transfusion. In reference to its cellular effects, ANH reports in the literature are scarce. Using electron microscopy (EM), we evaluated the effects of ANH on cardiac function and myocardial structure. Twenty-five dogs were prospectively randomized to a control group (n = 5) or to undergo ANH with 6% hydroxyethyl starch (HES; n = 10) or lactated Ringer's solution (LR; n = 10) administered, respectively, at a ratio of 1:1 or 1:3 to the volume of blood removed. Animals were gradually hemodiluted to a hematocrit of 10%, which was accomplished in 80 min. Pulmonary artery catheter and echocardiography were used to evaluate cardiac function. Myocardial samples were taken after the last time point for electron microscopy analysis. Data were obtained during five different stages of ANH, with a mean 20-min interval between each time point. Cardiac index increased significantly in both groups during ANH. A significant decrease in oxygen delivery and oxygen consumption, as well as an increase in oxygen extraction was verified in the LR group. Echocardiography demonstrated a decline in systolic function in the LR group at the end of the experiment. Electron microscopy analysis of the myocardium revealed slight lesions in cardiac cells in the HES group, and moderate-to-significant lesions in the LR group. In this animal species, ANH with HES resulted in better preservation of cardiac function, which was demonstrated by maintenance of systolic function and oxygenation parameters. Minor loss of cellular integrity with HES, in the presence of very low levels of hemoglobin, reinforces these findings.     

Preoperative autologous blood donation and acute normovolemic hemodilution affect intraoperative blood loss during sagittal split ramus osteotomy

IntroductionThis study aimed to determine the effects of acute normovolemic hemodilution (ANH) using low-molecular-weight hydroxyethyl starch (LMW-HES) on intraoperative blood loss in patients who had received preoperative autologous blood donation (PABD) and had undergone sagittal split ramus osteotomy (SSRO).MethodsPatients who had undergone SSRO were analyzed. All 250 patients received PABD of 400–800 mL until 2 weeks before surgery. ANH was performed by withdrawing whole blood, which was replaced by the same volume of LMW-HES. ANH was performed in 197 cases for 200 mL replacement (ANH-200) and in 5 cases for 400 mL replacement (ANH-400); it was not performed in 48 cases (ANH-0).ResultsBlood loss in ANH-200 was greater than that in ANH-0, despite no differences in hemoglobin concentrations at pre- and post-PABD, prothrombin time, activated partial thromboplastin time, fibrinogen and platelet counts between the groups before surgery. Blood loss increased as the total withdrawn blood (sum of PABD and ANH) increased.ConclusionIncreased intraoperative blood loss was associated with total withdrawn blood before the operation as well as ANH.     

急性等容血液稀释联合术中控制性降压在外科大手术中的应用

目的探讨急性等容血液稀释（acute normovolemic hemodilution,ANH）联合术中控制性降压（deliberatehypotension,DH）用于外科大手术的临床效果。方法将75例择期行外科大手术患者按随机数字表法分为联合组、降压组和对照组,每组25例。联合组采取ANH联合术中DH措施,降压组采取术中DH措施,对照组按常规处理。观察3组患者动、静脉穿刺置管完成后T0（基础值）、T1（ANH后）、T2（术毕即刻）和T3（术后24h）的血红蛋白（Hb）、红细胞压积（Hct）、血小板计数（PLT）水平的变化情况,手术时间和术中失血量、异体输血量、尿量及输血等情况。结果联合组T2PLT、Hb水平均明显高于降压组和对照组（P〈0.05或P〈0.01）,联合组T0、T1Hb、Hct、PLT水平与降压组、对照组比较差异均无统计学意义（均P〉0.05）,联合组、降压组手术时间均明显短于对照组（P〈0.05或P〈0.01）;联合组术中失血量、异体输血量和输血率均明显低于降压组和对照组（P〈0.05或P〈0.01）,降压组术中失血量、异体输血量和输血率均明显低于对照组（P〈0.05或P〈0.01）,联合组尿量多于降压组和对照组（P〈0.05）,降压组尿量与对照组比较差异无统计学意义（P〉0.05）。结论 ANH与DH联合用于外科大手术可显著减少出血量,不输或少输异体血,不失为围术期血液保护的有效措施。     

渐进抗阻训练结合阿仑膦酸钠提高绝经后骨质疏松症患者腰椎骨密度的初步研究

目的观察渐进抗阻训练结合阿仑膦酸钠疗法对提高绝经后骨质疏松症患者腰椎骨密度的效果。方法20例绝经后骨质疏松症患者随机分为A、B两组,各10例,A组接受渐进抗阻训练结合阿仑膦酸钠治疗,B组仅接受阿仑膦酸钠治疗,疗程均为3个月。治疗前后用双能X线吸收仪分别测量腰椎骨密度。结果治疗前,两组患者的骨密度差异无显著性意义;治疗3个月后,A组患者的腰椎骨密度提高(4.520±0.68)%,B组提高(0.100±0.01)%,两组间的差异有非常显著性意义(P<0.01)。结论渐进抗阻训练结合阿仑膦酸钠疗法可提高绝经后骨质疏松症患者腰椎的骨密度,效果明显优于单纯服用阿仑膦酸钠。     

超前镇痛对腰椎术后患者疼痛及睡眠质量的影响

目的:探讨超前镇痛对腰椎术后患者疼痛及睡眠质量的影响。方法:选取2019年7月至2020年6月谷城县人民医院收治的腰椎手术患者78例作为研究对象,随机分为对照组和观察组,每组39例,对照组应用常规镇痛干预,观察组应用超前镇痛干预。结果:观察组术后在3 h、6 h及12 h的评分均明显低于对照组(P<0.05),而术后24 h后的疼痛评分2组为比较差异有统计学意义(P>0.05)。观察组的入睡潜伏期为(31.1±1.5)min短于对照组的(54.9±1.8)min(P<0.05);观察组的实际睡眠时间(6.4±1.2)h长于对照组的(4.1±0.9)h(P<0.05);观察组的睡眠效率为(73.1±1.9)%好于对照组的(53.2±1.7)%(P<0.05)。结论:应用超前镇痛对腰椎术患者进行干预,患者的疼痛获得极大的减轻,提升了患者的睡眠效率,可应用推广。