超声引导下股神经阻滞联合股外侧皮神经阻滞用于老年患者髌骨骨折手术的临床效果  

Clinical effect of ultrasound-guided femoral nerve block combined with lateral femoral cutaneous nerve block for patella fracture surgery in elderly patients

作　　者：邓笔生 桂福鑫 蒋龙华 秦凯 汪雅 DENG Bi-sheng;GUI Fu-xin;JIANG Long-hua;QIN Kai;WANG Ya(Department of Anesthesiology,Guangxin District People′s Hospital,Jiangxi Province,Shangrao 334100,China)

机构地区：[1]江西省上饶市广信区人民医院麻醉科,江西上饶334100

出　　处：《中国当代医药》2021年第13期130-132,137,共4页China Modern Medicine

基　　金：江西省卫生健康委科技计划(20204827)。

摘　　要：目的探讨超声引导下股神经阻滞联合股外侧皮神经阻滞用于老年患者髌骨骨折手术的临床效果。方法选取2018年10月~2020年3月江西省广信区人民医院收治的100例老年髌骨骨折患者作为研究对象,按照随机数表法将其分为腰硬联合麻醉组(L组)和超声引导下股神经阻滞联合股外侧皮神经阻滞组(N组),每组各50例。比较两组麻醉入室时(T0)、麻醉结束平卧位时(T1)、手术开始时(T2)、手术结束时(T3)的血流动力学指标[舒张压(DBP)及收缩压(SBP)、心率(HR)],比较两组术后并发症总发生率。结果两组T1、T2、T3时DBP、SBP均较T0时降低,但N组T1、T2、T3时点DBP、SBP高于L组,组间、时点、组间与时点交互比较,差异有统计学意义(P<0.05)。两组T1、T2、T3时HR均较T0降低,不同时点比较,差异有统计学意义(P<0.05);组间、组间与时点交互比较,差异无统计学意义(P>0.05)。N组并发症总发生率低于L组,差异有统计学意义(P<0.05)。结论老年髌骨骨折手术采取超声引导下股神经阻滞联合股外侧皮神经阻滞,能够有效控制血流动力学,保持生命体征相对平稳,增强镇痛效果且安全性高。Objective To investigate the clinical effect of ultrasound-guided femoral nerve block combined with lateral femoral cutaneous nerve block for patella fracture surgery in elderly patients.Methods A total of 100 elderly patients with patella fractures who were admitted to Guangxin District People′s Hospital from October 2018 to March 2020 were selected as the research objects.According to the random number table method,they were divided into combined spinal-epidural anesthesia group(L group)and combined ultrasound-guided femoral nerve block Lateral femoral cutaneous nerve block group(N group),with 50 cases in each group.The hemodynamic indexes(diastolic blood pressure[DBP],systolic blood pressure[SBP],heart rate[HR])in the two groups at the time of anesthesia entry(T0),at the end of anesthesia(T1),at the beginning of surgery(T2)and at the end of surgery(T3)were compared.The total incidence of postoperative complications in the two groups was compared.Results The DBP and SBP at T1,T2 and T3 of the two groups were lower than those at T0,but the DBP and SBP at T1,T2,and T3 of the N group were higher than those of the L group,the difference in the interaction ratio between groups,time points,and between groups and time points was statistically significant(P<0.05).At T1,T2 and T3,HR in both groups was lower than that in T0,and the difference at different time points was statistically significant(P<0.05).There was no significant difference between groups,between groups and time point(P>0.05).The total incidence of complications in group N was lower than that in group L,and the difference was statistically significant(P<0.05).Conclusion The use of ultrasound-guided femoral nerve block combined with lateral femoral cutaneous nerve block in elderly patella fracture surgery can effectively control hemodynamics,keep vital signs relatively stable,enhance the analgesic effect and have high safety.

关 键 词：髌骨骨折 股神经阻滞 超声引导 神经阻滞 并发症 

分 类 号：R683.42[医药卫生—骨科学]