神经刺激仪引导下神经阻滞在老年高危病人全髋关节置换术中的应用研究  

THE APPLICATION OF NERVE BLOCK GUIDEDE BY NERVE STIMULATOR USED IN TOTAL HIP REPLACEMENT IN ELDERLY PATIENTS WITH HIGH RISK

作　　者：辛学东[1] 刘桧[1] 于建设[1] 

机构地区：[1]内蒙古医科大学附属医院麻醉科,内蒙古呼和浩特010050

出　　处：《内蒙古医科大学学报》2015年第6期530-533,共4页Journal of Inner Mongolia Medical University

基　　金：内蒙古自然科学基金(2013MS1127)

摘　　要：目的：探讨神经刺激仪引导下神经阻滞麻醉在老年高危病人髋关节手术中的应用价值。方法：将拟行髋关节手术的46例病人纳入本组研究对象，纳入者均为老年高危病人，按信封法随机分为两组，即对照组（硬膜外麻醉组）和观察组（神经刺激仪引导下椎旁联合腰丛-坐骨神经阻滞组），每组23例；记录两组神经阻滞起效时间、入室后（T0）、手术开始即刻（T1）、开始后10min（T2）、30min（T3）及术毕（T4）各时点的血流动力学变化；并对两组麻醉效果及围术期不适反应进行评估。结果：与对照组比较，观察组感觉、运动神经阻滞起效时间短（P 〈0.05），与 T0时比较，观察组 T1~T4各时点血流动力学变化更为平稳（P 〈0.05）；两组在麻醉效果近似的基础上，观察组在围术期不适反应发生率明显低于对照组（P 〈0.05）。结论：神经刺激仪引导下神经阻滞可以帮助麻醉医师精确定位，用于老年高危病人全髋关节置换术，麻醉效果可以满足需要且对生理功能干扰小，值得临床推广应用。Objective：To study the application value of nerve block guided by nerve stimulator used in total hip replacement in elderly patients with high-risk.Methods：46 hip surgery patients were included in this research object,all of them were elderly patients with high risk.According to the envelope method they were randomly divided into two groups, named control group （epidural anesthesia group ）and observation group （nerve stimulator guided by the vertebral joint lumbar plexus and sciatic nerve block group）,23 cases in each one.Two groups of nerve block,home after work time （T0）,surgery （T1）,immediately began after 10min （T2 ）,30min （T3 ） and finish the hemodynamic changes of each point were recorded.And the effects of two groups of anesthesia and perioperative reaction were evaluated. Results：Compared with control group,the observation group of sensory and motor nerve block had shorter effective time （P 〈0.05）.Compared with the T0,observation group T1 ~4 point hemodynamic changes was more smoothly （P 〈 0.05 ）;On the basis of similar anesthesia effect,the observation group had significantly lower incidence of discomfort reaction in perioperative than the control group （P 〈0.05）.Conclusion：The nerve block guided by nerve stimulator can help anesthesiologists pinpoint position,and used for high-risk patients with total hip replacement in old age.Its anesthetic effect can meet the needs and have little interference on physiological function.

关 键 词：老年高危 全髋关节置换术 神经阻滞 

分 类 号：R678.4[医药卫生—外科学]