高海拔地区腰丛联合骶旁坐骨神经阻滞在老年髋关节术中患者血浆S100β的观察  

Changes of Plasma S100β Levels in Elderly Patients Undergoing Hip Joint Operation with Lumbar Plexus Combined with Sciatic Nerve Block at High Altitude

作　　者：阿良德[1] 闫红秀[1] 贾珍[1] 石秀丽[1] A Liangde Yan Hongxiu Jia Zhen Shi Xiuli(Dept. of Anesthesia, The Affiliated Hospital Qinghai University（810001)

机构地区：[1]青海大学附属医院麻醉科,810001

出　　处：《高原医学杂志》2016年第2期19-22,共4页Journal of High Altitude Medicine

摘　　要：目的:分析比较不同麻醉方式对高海拔地区老年髋关节手术中的血浆S100β和术后认知功能障碍(POCD)的影响。方法:随机选取高海拔地区拟择期行髋关节手术的老年患者60例,随机分为两组,即全麻组(GA)和腰丛联合骶旁坐骨神经组(NB)。GA组对患者进行全麻后实施手术,NB组对患者进行腰丛联合骶旁坐骨神经阻滞后手术。观察比较两组患者手术前、后血浆S100β的浓度变化和POCD发生情况。结果:术后两组血浆S100β浓度均高于术前,且GA组明显高于NB组,GA组在术后1h、第二天8:00、术后第三天8:00的血浆S100β浓度均高于NB组(P<0.05,差异有统计学意义);GA组POCD发生率高于NB组(P<0.05,差异有统计学意义)。结论:高海拔地区老年患者髋关节手术腰丛联合骶旁坐骨神经阻滞相比全麻能够有效降低患者血浆S100β浓度和POCD发生率。Objective：To compare and analysis the effect of different anesthetic methods on plasma S100βand postoperative POCD in the elderly patients with hip joint operation at high altitude. Methods： Select 60 cases of patients with elderly patients with hip joint operation at high altitude, dividing them into general anesthesia group （GA） and lumbar plexus combined with sciatic nerve （NB） group. Each group contained 30 people via the method of generating random number. GA group used general anesthesia to perform surgery while the NB group used lumbar plexus and sciatic nerve block to perform surgery. Comparing the changes of plasma S100β concentration before and after operation and the situation of occurring POCD. Results ：The plasma concentration of S100β in both groups at postoperation were all higher than preoperation, and the GA group is obviously higher than the NB group . At the lh of postoperation, 8 am of the next day ,8 am of the third day, the plasma concentration of S100β of the GA group was higher than that of the NB group （P 〈 0.05 ）. The occurrence rate of POCD of the GA group was higher than that of the NB group （ P 〈 0.05 ）. Conclusion： The anesthesia method of blocking lumbar plexus and the sciatic nerve to be selected to perform the operation of hip replacement in the elderly patients at high altitude area can decrease the concentration of the plasma S100β and the lower the occurrence rate of POCD than general anesthesia .

关 键 词：腰丛 坐骨神经 老年 髋关节手术 血浆 S100Β 

分 类 号：R614[医药卫生—麻醉学]