B超引导下股神经阻滞镇痛和口服镇痛在老年股骨中上段骨折术前镇痛中的应用效果  

The Effect of Femoral Nerve Block and Oral Analgesia Guided by B-ultrasound on Preoperative Analgesia of Middle and Upper Femoral Fractures in Elderly Patients

作　　者：杨皓 张国云 王德财 郭云瑞 张业才 杨建明 YANG Hao;ZHANG Guo-yun;WANG De-cai;GUO Yun-rui;ZHANG Ye-cai;YANG Jian-ming(Dept.of Anesthesiology,The 2nd People’s Hospital of Kunming,Kunming Yunnan 650201,China)

机构地区：[1]昆明市第二人民医院麻醉科,云南昆明650201

出　　处：《昆明医科大学学报》2021年第9期138-143,共6页Journal of Kunming Medical University

基　　金：昆明市卫生健康委员会卫生科研基金资助项目(2020-04-11-111)。

摘　　要：目的探讨对比B超引导下股神经阻滞镇痛(femoral nerve block,FNB)和口服镇痛在老年股骨中上段骨折术前镇痛中的应用效果。方法选取昆明市第二人民医院2018年4月至2020年11月确诊并治疗的84例股骨骨折(femoral fractures,FF)老年患者,所有患者骨折位置均为中上段骨折,采取随机数字表法进行分组,对照组应用口服镇痛,研究组应用B超引导下FNB。使用视觉模拟疼痛(VAS)评分评估2组镇痛前、镇痛72 h后的效果指标:主动活动VAS(AVAS)评分、被动活动VAS(PVAS)评分、静息VAS(RVAS)评分水平差异;2组经静脉自控镇痛(PCIA)总按压及有效按压次数。数据采集时间段:开始镇痛后72 h;2组的不良反应。结果镇痛前,2组患者AVAS评分、PVAS评分、RVAS评分无统计学差异(P>0.05);镇痛72 h后,研究组AVAS评分、PVAS评分、RVAS评分水平均低于对照组具有统计学意义(P<0.05);研究组按压PCIA总次数及有效次数均低于对照组具有统计学意义(P<0.05);研究组不良反应低于对照组具有统计学意义(P<0.05)。结论给予FF患者在术前镇痛时应用B超引导下FNB,可更为有效缓解患者的疼痛感,镇痛效果理想,且不良反应较低。Objective To investigate and compare the application effect of B-ultrasono-guided femoral nerve block(FNB)and the oral analgesia in preoperative analgesia of middle and upper femoral fractures in the elderly.Methods We selected 84 elderly patients with femoral fractures(FF)diagnosed and treated in Kunming Second People’s Hospital from April 2018 to November 2020.All patients had middle and upper segment fractures.We divided the group by random number table.The control group was treated with oral analgesia and the study group was treated with FNB guided by B-ultrasound.We used visual analogue pain score(VAS)to evaluate the effect indexes of the two groups before and 72 hours after analgesia:the difference of active activity VAS(AVAs)score,passive activity VAS(PVAs)score and tranqillization VAS(RVAS)score;Total compression and effective compression times of patient-controlled intravenous analgesia(PCIA)in the two groups.Data collection period:72 hours after the beginning of analgesia;Adverse reactions in the two groups.Results Before analgesia,there were no significant differences in AVAS score,PVAS score and RVAS score between 2 groups(P>0.05).After 72 hours of the analgesia,AVAS score,PVAS score and RVAS score in the study group were lower than those in the control group,with the statistical significance(P<0.05).The total and effective times of pressing PCIA in the study group were lower than those in the control group with statistical significance(P<0.05).The adverse reactions in the study group were lower than those in the control group,with the statistical significance(P<0.05).Conclusion The application of FNB guided by B-ultrasound in the preoperative analgesia for FF patients can more effectively relieve the pain feeling of patients,with ideal analgesic effect and low adverse reactions.

关 键 词：B超引导 股神经阻滞镇痛 口服镇痛 不良反应 效果 

分 类 号：R614[医药卫生—麻醉学]