全髋关节置换术中联用神经阻滞麻醉对老年患者术后疼痛及免疫功能的影响  

Effects of combined nerve block anesthesia on postoperative pain and immune function in elderly patients undergoing total hip arthroplasty

作　　者：赵红波 张占军[2] ZHAO Hongbo;ZHANG Zhanjun(Anesthesiology Department,the People's Hospital of Wen County,Jiaozuo 454850;Anesthesiology Department,Jiaozuo People's Hospital,Jiaozuo 454000,China)

机构地区：[1]焦作市温县人民医院麻醉科,河南焦作454850 [2]焦作市人民医院麻醉科,河南焦作454000

出　　处：《临床医学研究与实践》2022年第20期96-98,共3页Clinical Research and Practice

摘　　要：目的分析神经阻滞麻醉在老年患者全髋关节置换术(THA)中的应用效果。方法选择2018年1月至2019年12月我院收治的96例行THA的老年患者为研究对象,根据麻醉方案不同将其分为对照组(n=48,全身麻醉)和观察组(n=48,腰丛复合坐骨神经阻滞麻醉)。比较两组的麻醉效果。结果术后6 h,两组患者的皮质醇(Cor)、白细胞介素-6(IL-6)水平及视觉模拟评分法(VAS)评分低于术后2 h,且观察组低于对照组(P<0.05)。术后48 h,两组患者的白细胞分化抗原3阳性(CD3^(+))、白细胞分化抗原4阳性(CD4^(+))、CD4^(+)/CD8^(+)高于术后6 h,白细胞分化抗原8阳性(CD8^(+))低于术后6 h,且观察组优于对照组(P<0.05)。术后48 h,两组患者的肌力评分、最大屈曲度、最大外展活动度高于术后3 h,且观察组高于对照组(P<0.05)。结论神经阻滞麻醉应用在THA中有利于减轻老年患者术后的疼痛程度,促进肢体功能早期康复。Objective To analyze the application effect of nerve block anesthesia in elderly patients undergoing total hip arthroplasty(THA).Methods A total of ninety-six elderly patients who underging THA in our hospital from January 2018 to December 2019 were selected as the study objects and divided into control group(n=48,general anesthesia)and observation group(n=48,lumbar plexus combined with sciatic nerve block anesthesia)according to different anesthesia schemes.The anesthesia effects of the two groups were compared.Results At 6 h after operation,the levels of cortisol(Cor),interleukin-6(IL-6)and visual analogue scale(VAS)score in the two groups were lower than those at 2 h after operation,and those in the observation group were lower than the control group(P<0.05).At 48 h after operation,the cluster of differentiation 3 positive(CD3^(+)),cluster of differentiation 4 positive(CD4^(+)),CD4^(+)/CD8^(+)in the two groups were higher than those at 6 h after operation,the cluster of differentiation 8 positive(CD8^(+))was lower than that at 6 h after operation,and those in the observation group were better than the control group(P<0.05).At 48 h after operation,the muscle strength score,maximum flexion and maximum abduction activity of the two groups were higher than those at 3 h after operation,and those of the observation group were higher than the control group(P<0.05).Conclusion The nerve block anesthesia applied in THA is conducive to reducing postoperative pain degree of elderly patients and promoting early rehabilitation of limb function.

关 键 词：全髋关节置换术 老年 神经阻滞麻醉 免疫功能 

分 类 号：R614.4[医药卫生—麻醉学]