髋关节囊周围神经阻滞对髋关节置换术患者术后镇痛、应激反应及安全性的影响观察  

Observation on the Influence of Peripheral Nerve Block of Hip Joint Capsule for Postoperative Analgesia and Stress Response and Safety of Patients with Hip Arthroplasty

作　　者：张庆洪[1] 马达 刘洋[1] 张凌宇[1] ZHANG Qinghong;MA Da;LIU Yang;ZHANG Lingyu(The First Affiliated Hospital of Xiamen University,Xiamen 361000,China;不详)

机构地区：[1]厦门大学附属第一医院,福建厦门361000

出　　处：《中外医学研究》2022年第32期13-17,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探究髋关节囊周围神经阻滞对髋关节置换术患者术后镇痛、应激反应及安全性的影响。方法:将2019年11月-2022年1月厦门大学附属第一医院收治的80例髋关节置换术患者根据随机数字表法分为对照组和观察组,各40例。对照组术前给予舒芬太尼静脉注射,观察组术前给予髋关节囊周围神经阻滞。比较两组的首次补救镇痛时间、24 h补救镇痛药物用量、24 h镇痛泵有效按压次数、不良反应发生率、手术前后的静态及动态疼痛数字评分法(NRS)评估结果及应激反应指标[血糖(Glu)、皮质醇(Cor)、去甲肾上腺素(NE)及肾上腺素(E)]。结果:观察组的首次补救镇痛时间显著长于对照组,24 h补救镇痛药物用量及镇痛泵有效按压次数显著少于对照组,差异均有统计学意义(P<0.05)。两组的不良反应发生率比较,差异无统计学意义(P>0.05)。术前两组的静态及动态NRS评估结果及应激反应指标比较,差异无统计学意义(P>0.05);术后6、12、24 h观察组的静态及动态NRS评估结果及应激反应指标显著优于对照组,差异均有统计学意义(P<0.05)。结论:髋关节囊周围神经阻滞可有效减轻髋关节置换术患者术后疼痛及应激反应,安全性好,在髋关节置换术患者中的应用价值较高。Objective:To investigate the influence of peripheral nerve block of hip joint capsule for postoperative analgesia,stress response and safety of patients with hip arthroplasty.Method:A total of 80 patients with hip arthroplasty in the First Affiliated Hospital of Xiamen University from November 2019 to January 2022 were divided into control group and observation group according to the random number table method,with 40 cases in each group.The control group was given Sufentanil intravenous injection before operation,and the observation group was given hip joint capsule peripheral nerve block before operation.Then the time of first remedial analgesia,dosage of 24 hours remedial analgesics,effective pressing times of 24 hours analgesia pump,adverse reactions rates,static and dynamic pain numerical rating scale(NRS)evaluation results and stress response indexes[blood glucose(Glu),cortisol(Cor),norepinephrine(NE)and epinephrine(E)]before and after the operation of two groups were compared.Result:The time of first remedial analgesia in the observation group was significantly longer than that in the control group,the dosage of 24 hours remedial analgesics and effective pressing times of 24 hours analgesia pump were significantly less than those in the control group,the differences were statistically significant(P<0.05).The adverse reactions rates of two groups were compared,the differences were not statistically significant(P>0.05).There were no significant differences in the static and dynamic NRS evaluation results and stress response indexes of two groups before operation(P>0.05).The static and dynamic NRS evaluation results and stress response indexes of observation group at 6,12,24 hours after operation were significantly better than those in the control group,the differences were statistically significant(P<0.05).Conclusion:The peripheral nerve block of hip joint capsule can significantly improve the postoperative pain and stress response of patients with hip arthroplasty,its safety is better,so its application val

关 键 词：髋关节囊周围神经阻滞 髋关节置换术 镇痛 应激反应 

分 类 号：R687.4[医药卫生—骨科学]