目的 分析不同麻醉方式对老年骨水泥固定半髋关节置换术发生骨水泥植入综合征的影响。方法 选取广西国际壮医医院2023年1月—2024年3月收治的70例行骨水泥固定半髋关节置换术治疗的老年患者为研究对象,根据麻醉方式不同将其分为观察组和对照组,每组各35例,观察组患者施行腰硬联合麻醉,对照组患者施行硬膜外麻醉,对比两组患者麻醉前（T₀）和麻醉起效5 min时（T₁）的中心静脉压（CVP）水平、麻醉起效时间、苏醒时间、肌松效果、镇痛效果、骨水泥植入综合征发生率及术后3个月的认知功能评分、生活质量评分。结果 T₀时,两组患者CVP水平差异无统计意义（P>0.05）;T₁时,观察组CVP水平有所升高,但与T₀时对比,差异无统计意义（P>0.05）,对照组CVP水平则明显降低,显著低于T₀时（P<0.05）。麻醉起效时间、苏醒时间对比,观察组短于对照组（P<0.05）;麻醉药物用量、骨水泥植入综合征发生率对比,观察组低于对照组（P<0.05）;肌松效果及镇痛效果对比,观察组优于对照组（P<0.05）;术后3个月的认知功能评分、生活质量评分对比,观察组高于对照组（P<0.05）。结论 对行骨水泥固定半髋关节置换术治疗的老年患者施行腰硬联合麻醉,麻醉效果优于硬膜外麻醉,且能有效保障患者血流动力学稳定和降低其骨水泥植入综合征发生率。

Objective To analyze the effects of different anesthesia methods on the occurrence of bone cement implantation syndrome in elderly patients undergoing bone cement hemiarthroplasty. Methods A total of 70 elderly patients who underwent bone cement hemiarthroplasty from January 2023 to March 2024 at Guangxi International Zhuang Medical Hospital were selected as study subjects and divided into an observation group and a control group based on different anesthesia methods, with 35 patients in each group. The observation group received combined spinal epidural anesthesia, while the control group received epidural anesthesia. The study compared central venous pressure （CVP） levels before anesthesia （T₀） and 5 min after anesthesia onset （T₁）, anesthesia onset time, recovery time, muscle relaxation effect, analgesic effect, incidence of bone cement implantation syndrome, and cognitive function scores and quality of life scores 3 months post-surgery between the two groups. Results At T₀, there was no statistically significant difference in CVP levels between the two groups of patients（P>0.05）. At T₁,the CVP levels in the observation group increased slightly, but there was no statistically significant difference compared to T₀ （P<0.05）, and the control group showed a significant decrease in CVP levels compared to T₀ （P>0.05）. The observation group showed shorter anesthesia onset time and recovery time, as well as lower dosage of anesthetic drugs and incidence of bone cement implantation syndrome than the control group （P<0.05）. The muscle relaxation and analgesic effects in the observation group were superior to those in the control group （P<0.05）.The cognitive function score and quality of life score at 3 months after surgery in the observation group were higher than those in the control group （P<0.05）. Conclusion Lumbar epidural anesthesia is more effective than epidural anesthesia in elderly patients undergoing bone cement hemiarthroplasty, and can effectively ensure hemodynamic stability and reduce the incidence of bone cement implantation syndrome.