超声引导下髂筋膜阻滞联合轻比重腰麻在老年髋部骨折患者手术中的应用效果  

Application of ultrasound-guided iliac fascia block combined with light specific gravity lumbar anesthesia in elderly patients with hip fractures

作　　者：刘小鸣[1] 陈芳荣 邹雨华 LIU Xiaoming;CHEN Fangrong;ZOU Yuhua(Department of Anesthesiology,Nanfeng County People's Hospital,Jiangxi province,Fuzhou,Jiangxi,344500,China)

机构地区：[1]江西省南丰县人民医院麻醉科,江西抚州344500

出　　处：《当代医学》2022年第19期46-49,共4页Contemporary Medicine

摘　　要：目的 探究超声引导下髂筋膜阻滞联合轻比重腰麻在老年髋部骨折患者手术中的应用效果。方法 回顾性分析2018年3月至2020年4月本院收治的82例老年髋骨骨折患者的临床资料。将接受轻比重腰麻的患者作为对照组(n=40),将行超声引导下髂筋膜阻滞联合轻比重腰麻的患者作为联合组(n=42),比较两组麻醉后患肢制动下的视觉模拟评分法(RVAS)评分、患肢股四头肌等长收缩下的视觉模拟评分法(PVAS)评分、警觉/镇静评分(OAA/S)、麻醉效果、术后并发症及不同时点不同状态视觉模拟评分法(VAS)评分。结果 麻醉后,联合组RVAS、PVAS及OAA/S评分均低于对照组(P<0.05)。联合组感觉阻滞见效时间、感觉阻滞成功时间、运动阻滞起效时间及运动阻滞成功时间均短于对照组(P<0.05)。麻醉后2 h(T1)、4 h(T2)、8 h(T3)、24 h(T4),联合组静息状态VAS评分均低于对照组(P<0.05),T2、T3、T4,联合组运动状态VAS评分均低于对照组(P<0.05)。两组术后并发症发生率比较差异无统计学意义。结论 老年髋部骨折患者手术行超声引导下髂筋膜阻滞联合轻比重腰麻镇痛效果显著,可降低患者疼痛程度,具有较高临床价值。Objective To explore the effect of ultrasound-guided iliac fascia block combined with light specific gravity lumbar anesthesia in the operation of elderly patients with hip fractures. Methods The clinical data of 82 elderly patients with hip fracture admitted to our hospital from March 2018 to April 2020 were retrospectively analyzed. The patients who received hypobaric spinal anesthesia were selected as the control group(n=40), and the patients who underwent ultrasound-guided iliaca fascia block combined with hypobaric spinal anesthesia were selected as the combined group(n=42), the RVAS, PVAS and OAA/S scores, anesthesia effect, postoperative complications and VAS scores at different time points and different states were compared between the two groups after anesthesia. Results RVAS, PVAS and OAA/S scores of the combined group were all lower than those of the control group(P<0.05). The effect time, successful time of sensory block, effective time of motor block and successful time of motor block in the combined group were shorter than those in the control group(P<0.05). At 2 h(T1), 4 h(T2), 8 h(T3), and 24 h(T4) after anesthesia, the resting state VAS score of the combined group was lower than that of the control group(P<0.05), at T2, T3, and T4, the VAS scores of exercise state in the combined group were lower than those in the control group(P<0.05). There was no statistically significant difference in postoperative complications between the two groups. Conclusion Ultrasound-guided iliac fascia block combined with light specific gravity lumbar anesthesia has clear analgesic effect in elderly patients with hip fracture, and has important clinical value.

关 键 词：超声 髂筋膜阻滞 髋骨骨折 疼痛评分 轻比重腰麻 老年患者 

分 类 号：R614[医药卫生—麻醉学]