超声髂腹下神经和髂腹股沟神经阻滞对骨盆骨折手术患者围术期影响  

Perioperative effect of ultrasonic iliohypoabdominal and ilioinguinal nerve block on pelvic fracture patients

作　　者：杨丽 张博卿 黄海珍 毕艳 古粤峰 肖庆华 邱卫东 YANG Li;ZHANG Bo-qing;HUANG Hai-zhen;BI Yan;GU Yue-feng;XIAO Qing-hua;QIU Wei-dong(Department of Anesthesiology,the First People′s Hospital of Shaoguan City,Guangdong Province,Shaoguan 512000,China)

机构地区：[1]广东省韶关市第一人民医院麻醉科,广东韶关512000

出　　处：《中国当代医药》2021年第16期125-128,共4页China Modern Medicine

基　　金：广东省韶关市卫生健康科研项目课题(Y21116)。

摘　　要：目的探讨超声髂腹下神经(IHN)和髂腹股沟神经(IIN)阻滞在骨盆骨折手术患者中的应用效果。方法选取2018年1月~2020年12月在韶关市第一人民医院行内固定手术治疗的90例骨盆骨折患者作为研究对象,按随机数字表法将其分为超声组与对照组,每组各45例。超声组患者行超声引导IHN及IIN阻滞复合全麻,对照组患者实施常规全麻。比较两组患者不同时间点的血流动力学、术中麻醉药物使用量、术后术区疼痛程度和不良反应发生情况。结果超声组患者手术开始前5 min(T_(0))、手术开始时(T_(1))、手术30 min(T_(2))、手术60 min(T_(3))、手术结束时(T_(4))、全麻拔管后15 min(T_(5))的平均动脉压(MAP)、心率(HR)比较,差异无统计学意义(P>0.05)。对照组患者T_(1)、T_(2)时的MAP、HR低于T_(0),差异有统计学意义(P<0.05)。两组患者T_(3)、T_(4)、T_(5)时的MAP、HR比较,差异无统计学意义(P>0.05)。超声组患者的丙泊酚、瑞芬太尼用量少于对照组,差异统计学意义(P<0.05);两组患者的舒芬太尼、罗库溴铵用量比较,差异无统计学意义(P>0.05)。超声组患者术后2、12、24、48 h术区疼痛评分低于对照组,术后不良反应总发生率低于对照组,差异统计学意义(P<0.05)。结论超声引导IHN及IIN阻滞复合全麻能够有效维持骨盆骨折手术中血流动力学稳定,减少麻醉药物使用,减轻术后疼痛,减少不良反应发生。Objective To investigate the perioperative effects of ultrasound iliac inferior abdominal nerve(IHN)and iliac ventral sulcus nerve(IIN)block on pelvic fracture surgery.Methods A total of 90 patients with pelvic fractures who underwent internal fixation surgery in the First People′s Hospital of Shaoguan City from January 2018 to December 2020 were selected as the research subjects.According to random number table method,they were divided into the ultrasound group and the control group,with 45 cases in each group.Patients in the ultrasound group received ultrasound-guided IHN and IIN block combined general anesthesia,while patients in the control group received routine general anesthesia.Hemodynamics,intraoperative anesthesia dosage,postoperative pain in the operative area and the incidence of adverse reactions were compared between the two groups at different time points.Results There were no statistically significant differences in mean arterial pressure(MAP)and heart rate(HR)in the ultrasound group at 5 min before surgery(T_(0)),the beginning of surgery(T_(1)),30 min(T_(2)),60 min(T_(3)),at the end of surgery(T_(4)),and 15 min after extubation under general anesthesia(T_(5))(P>0.05).MAP and HR of the control group at T_(1) and T_(2) were lower than T_(0),the differences were statistically significant(P<0.05).There were no statistically significant differences in MAP and HR at T_(3),T_(4) and T_(5) between the two groups(P>0.05).The dosage of Propofol and Remifentanil in the ultrasound group were less than those in the control group,and the differences were statistically significant(P<0.05).There were no statistically significant differences in the dosage of Sufentanil and Rocuronium between the two groups(P>0.05).The postoperative pain scores in the ultrasound group at 2,12,24 and 48 h were lower than those in the control group,and the total incidence of postoperative adverse reactions was lower than that in the control group,and the differences were statistically significant(P<0.05).Conclusion Ultrasound-guid

关 键 词：骨盆骨折 超声 髂腹下神经 髂腹股沟神经 血流动力学 术后疼痛程度 

分 类 号：R614.4[医药卫生—麻醉学]