双侧股神经阻滞用于双膝关节置换术患者的麻醉效果和对血清炎性因子水平的影响  

Anesthetic Effect of Bilateral Femoral Nerve Block on the Patients Undergoing Double Knee Arthroplasty and its Effect on the Serum Inflammatory Factor Levels

作　　者：单兆亚 孔重红 毛兴华 刘海云 赵一凡 SHAN Zhao-ya;KONG Zhong-hong;MAO Xing-hua;LIU Hai-yun;ZHAO Yi-fan(Anesthesiology department,Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine,Xianyang,Shaanxi,752000,China;Anesthesiology department,Central Hospital ofTongchuan Mining Bureau,Tongchuan,Shaanxi,727000,China)

机构地区：[1]陕西中医药大学附属医院麻醉科,陕西咸阳752000 [2]铜川市矿务局中心医院麻醉科,陕西铜川727000

出　　处：《现代生物医学进展》2019年第18期3519-3522,共4页Progress in Modern Biomedicine

基　　金：陕西省科技计划项目（2015SF072）

摘　　要：目的:研究双侧股神经阻滞术用于双膝关节置换术患者麻醉效果和对患者血清炎性因子水平的影响。方法:选择2015年10月~2018年10月在我院进行双膝关节置换术的110例患者,按照其入院顺序经随机数字表法分为两组,每组55例。对照组采用全身麻醉,研究组采用双侧股神经阻滞联合全身麻醉。比较两组的麻醉情况,治疗前后血清炎性因子白介素6(IL-6)、C反应蛋白(CRP)、舒张压(DBP)、收缩压(SBP)、心率(HR)水平的变化。结果:两组麻醉时间比较差异无统计学意义(P>0.05);研究组拔管、恢复室停留和苏醒时间均显著短于对照组(P<0.05)。两组术后24 h、48 h血清炎性因子IL-6、CRP水平均高于术前,但研究组以上指标均显著低于对照组(P<0.05);两组术中DBP、SBP、HR水平均较术前显著降低(P<0.05),但研究组DBP、SBP、HR水平均显著高于对照组(P<0.05),两组术后DBP、SBP、HR水平比较差异均无统计学意义(P<0.05)。结论:与单纯采用全身麻醉相比,双侧股神经阻滞可有效改善双膝关节置换术患者的麻醉效果,并降低其血清炎症因子和稳定其血流动力学。Objective: To investigate the anesthetic effect of bilateral femoral nerve block on the patients undergoing double knee arthroplasty and its effect on the serum inflammatory factor levels. Methods: 110 patients who underwent double knee arthroplasty in our hospital from October 2015 to October 2018 were randomly divided into two groups according to their admission order with 55 patients in each group. General anesthesia was used in the control group, and bilateral femoral nerve block combined with general anesthesia was used in the observation group. The changes of serum interleukin-6(IL-6), c-reactive protein(CRP), diastolic blood pressure(DBP),systolic blood pressure(SBP) and heart rate(HR) levels were compared between the two groups before and after treatment. Results:There was no significant difference in the anesthesia time between the two groups(P>0.05). The extubation time, recovery room retention time and recovery time of observation group were significantly shorter than those of the control group(P<0.05). The serum IL-6 and CRP levels in both groups were higher at 24 h and 48 h after surgery than those before surgery, but the above indexes in the study group were significantly lower than those in the control group(P<0.05). There was no difference in the DBP, SBP and HR levels between the two groups(P>0.05). The intraoperative DBP, SBP and HR levels of both groups were significantly lower than those of the control group(P<0.05), but the DBP, SBP and HR levels of study group were significantly higher than those of the control group(P <0.05), and the postoperative DBP, SBP and HR levels of both groups showed no statistically significant difference(P<0.05). Conclusion: Compared with general anesthesia alone, bilateral femoral nerve block can effectively improve the anesthetic effect of patients with double knee arthroplasty, and stabilize its serum inflammatory factors and hemodynamics.

关 键 词：双侧股神经阻滞 双膝关节置换术 麻醉效果 炎性因子 

分 类 号：R687.4[医药卫生—骨科学]