连续腰丛神经阻滞术后镇痛对股骨颈骨折患者术后炎性因子平衡的影响  

After continuous postoperative lumbar plexus nerve block, effect of analgesia of postoperative inflammatory cytokines balance to patients with femoral neck fracture

作　　者：谢文吉[1] 赵桀[1] 谢文钦[1] 黄燕芳[1] 康振明[1] 

机构地区：[1]福建医科大学附属泉州第一医院,福建泉州362000

出　　处：《医药前沿》2015年第14期17-19,共3页Journal of Frontiers of Medicine

基　　金：泉州市技术研究与开发项目（2013-Z-61）

摘　　要：目的：探讨连续腰丛神经阻滞术后镇痛对股骨颈骨折术后血中炎性因子平衡的影响。方法：将100例股骨颈骨折患者按随机数字表法分为连续腰丛神经阻滞术后镇痛（PCNA）组和患者自控静脉镇痛（PCIA）组，观察两组患者术后24h视觉模拟评分（VAS评分）；测定两组麻醉前、切皮后5min、手术结束时以及术后24～48h血浆白细胞6（IL-6）、IL-10比值。结果：两组术后24～48hVAS评分差异无统计学意义（P〉0．05）。两组IL-6比值在麻醉前、切皮后5min、手术结束各时点比较，差异无统计学意义（P〉0．05）；术后24～48hIL-6／IL-10连续腰丛神经阻滞术后镇痛（PCNA）组为（3．9±2．7），PCIA组为（10．5±6．7），两组比较差异有统计意义（P〈0．01）。结论：PCNA对股骨颈骨折术后炎性因子平衡的影响较小，有利于减轻炎症反应。Objective Explore the postoperative analgesia in continuous lumbar plexus nerve block for femoral neck fractures in the effect of inflammatory cytokines balance in the postoperative blood. Methods 100 patients with femoral neck fracture according to random number table method were randomly divided into continuous lumbar plexus nerve block analgesia （PCNA） and postoperative patient controlled intravenous analgesia （PCIA） group,Observe two groups of patients with postoperative 24 visual analogue scale （VAS score）; The determination of the two groups before anesthesia, cut skin after 5 min, at the end of surgery and postoperative 24 - 48 h plasma leucocyte 6 （IL 6） and IL - 10 ratio. Results Two groups of postoperative 24 - 48 hVAS score difference has no statistical significance （P 〉 0.05）. Two groups of IL - 6 ratio before anesthesia, cut skin surgery after 5 rain, end each time, there was no statistically significant difference （P 〉 0.05）; Postoperative 24 - 48 IL-6/IL - 10 continuous lumbar plexus nerve block for postoperative analgesia （PCNA） group （3.9±2.7）, （10.5±6.7） for PCIA group, are similar between the two groups have statistical significance （P 〈 0.01）. Condusion PCNA of femoral neck fracture has little effect on postoperative inflammatory cytokines balance, is helpful to reduce inflammation reaction.

关 键 词：连续腰丛神经阻滞 股骨颈骨折 术后镇痛 白细胞介素6 白细胞介素10 

分 类 号：R614[医药卫生—麻醉学]