超声引导下髂筋膜联合腰骶丛神经阻滞在老年患者髋关节置换术中的应用效果  

Effect of ultrasound-guided iliac fascia combined with lumbosacral plexus block on elderly patients undergoing hip replacement

作　　者：王伟[1] 段志强[1] 刘晋如 Wang Wei;Duan Zhiqiang;Liu Jinru(Department of Anesthesiology,Bayannur City Hospital,Bayannur 015000,China)

机构地区：[1]内蒙古自治区巴彦淖尔市医院麻醉科,015000

出　　处：《中国实用医刊》2020年第23期14-17,共4页Chinese Journal of Practical Medicine

基　　金：内蒙古自治区卫生计生委医疗卫生计生科研计划项目(2019032)。

摘　　要：目的探讨超声引导下髂筋膜联合腰骶丛神经阻滞在老年患者髋关节置换术中的应用效果。方法抽取巴彦淖尔市医院2018年3月至2019年12月行髋关节置换术老年患者82例,以随机数字表法将患者分为研究A组与研究B组,每组41例。研究A组于超声引导下行髂筋膜联合腰骶丛神经阻滞,研究B组采用全身麻醉。比较两组术后3、12、24 h视觉模拟评分法(VAS)评分,麻醉前、术中、术后平均动脉压(MAP)、心率(HR)变化,术后舒芬太尼、24 h静脉自控镇痛(PCA)用量,术后并发症发生情况。结果研究A组术后3、12、24 h VAS评分低于研究B组,差异有统计学意义(P<0.05)。麻醉前,两组MAP、HR水平比较差异未见统计学意义(P>0.05)。术中,研究B组MAP、HR水平低于麻醉前,且研究B组上述指标低于研究A组(P<0.05);术后,两组MAP、HR水平与术中比较差异未见统计学意义(P>0.05V),且研究B组MAP、HR水平低于研究A组(P<0.05)。研究A组术后舒芬太尼、24 h PCA用量低于研究B组,差异有统计学意义(P<0.05);术后,研究A组并发症发生率低于研究B组(P<0.05)。结论老年患者髋关节置换术中应用超声引导下髂筋膜联合腰骶丛神经阻滞进行麻醉处理,能够提高麻醉阻滞效果,保持麻醉后血流动力学稳定,改善术后镇痛水平,减轻疼痛感受,减少麻醉药物使用,减少并发症影响,相较于全身麻醉更具有应用价值。Objective To study the effect of ultrasound-guided iliac fascia combined with lumbosacral plexus block on elderly patients undergoing hip replacement surgery.Methods A total of 82 elderly patients undergoing hip arthroplasty in Bayannur City Hospital from March 2018 to December 2019 were selected.The patients were divided into study group A and study group B by random number table method,with 41 cases in each group.The study group A underwent ultrasound-guided iliac fascia combined with lumbosacral plexus block,the study group B was given general anesthesia.Visual analogue scale(VAS)scores were compared between the two groups at 3,12 and 24 h after operation.The changes of mean arterial pressure(MAP)and heart rate(HR)before,during and after anesthesia were compared between the two groups.The dosage of sufentanil,24 h patient-controlled intravenous analgesia(PCA)and postoperative complications were compared between the two groups.Results The VAS scores of study group A were lower than those of study group B at 3,12 and 24 h after operation(P<0.05).Before anesthesia,there was no statistically significant difference in MAP or HR level between the two groups(P>0.05).During the operation,the MAP and HR levels of study group B were lower than those before anesthesia,and lower than those of study group A(P<0.05).After operation,there was no statistically significant difference in MAP or HR level between the two groups,compared with those before operation(P>0.05),and the MAP and HR levels of study group B were lower than those of study group A(P<0.05).The dosage of sufentanil and 24 h PCA in study group A was lower than that in study group B,and the difference was statistically significant(P<0.05).After the operation,the incidence of complications in study group A was lower than that in study group B(P<0.05).Conclusions Ultrasound-guided iliac fascia combined with lumbosacral plexus block on elderly patients undergoing hip replacement surgery,can improve the effect of anesthesia block,maintain the stability of hemodynami

关 键 词：髋关节 置换术 超声引导 髂筋膜联合腰骶丛神经阻滞 血流动力学 

分 类 号：R614[医药卫生—麻醉学]