镇痛麻醉护理在腰骶丛神经阻滞联合全麻高龄全髋关节置换术患者中的应用价值  

The Application Value of Analgesic Anesthesia Care in Patients with Lumbosacral Plexus Block Combined with General Anesthesia in Elderly Total Hip Arthroplasty.

作　　者：谢宾 魏娇妮 邵军发 涂平花 XIE Bin;WEI Jiaoni;SHAO Junfa;TU Pinghua(Nanchang First Hospital,Nanchang 331800,China)

机构地区：[1]南昌市第一医院,江西南昌331800

出　　处：《中国医学创新》2023年第9期82-86,共5页Medical Innovation of China

基　　金：江西省卫生健康委科技计划项目(SKJP220217709)。

摘　　要：目的:探究镇痛麻醉护理在腰骶丛神经阻滞联合全麻高龄全髋关节置换术患者中的应用价值。方法:回顾性分析2021年3月-2022年3月南昌市第一医院手术室收治的80例接受单侧人工全髋关节置换术并行腰骶丛神经阻滞联合全麻的高龄患者的临床资料,将2021年3-9月入院的患者纳入对照组,2021年10月-2022年3月入院的患者纳入观察组,各40例。对照组采用常规的护理方案,观察组在对照组的基础上实施镇痛麻醉护理。比较两组麻醉情况、术后恢复指标、不良反应发生情况和髋关节功能、恐动症、疼痛评分。结果:观察组麻醉依从率高于对照组,术中麻醉药物追加率低于对照组(P<0.05)。术前,两组髋关节功能和恐动症评分比较,差异均无统计学意义(P>0.05);术后3 d,两组髋关节功能评分均高于术前,恐动症评分均低于术前,且观察组髋关节功能评分高于对照组,恐动症评分低于对照组(P<0.05)。观察组苏醒时间、下床时间、患肢锻炼时间及住院时间均短于对照组(P<0.05)。术前,两组视觉模拟评分法(VAS)评分比较,差异无统计学意义(P>0.05);与术前比较,术后12、24、48 h,两组评分均降低,且观察组均低于对照组(P<0.05)。观察组不良反应发生率为7.50%,低于对照组的25.00%(χ^(2)=4.501,P=0.034)。结论:在腰骶丛神经阻滞联合全麻高龄全髋关节置换术患者中应用镇痛麻醉护理,能提高术中麻醉效果,改善患者的疼痛程度,使患者术后舒适度得到极大提升。Objective:To investigate the application value of analgesic anesthesia care in patients with lumbosacral plexus block combined with general anesthesia in elderly total hip arthroplasty.Method:The clinical data of 80 elderly patients received unilateral total hip replacement combined with lumbosacral plexus block combined with general anesthesia admitted to the Operating Room of Nanchang First Hospital from March 2021 to March 2022 were retrospectively analyzed,patients admitted from March to September 2021 were included in the control group,and patients admitted from October 2021 to March 2022 were included in the observation group,with 40 cases in each group.The control group was treated with routine nursing plan,and the observation group was treated with analgesic anesthesia nursing on the basis of the control group.Anesthesia,postoperative recovery indexes,occurrence of adverse reactions,hip function,kinesiophobia and pain scores were compared between the two groups.Result:The compliance rate of anesthesia in the observation group was higher than that in the control group,and the addition rate of anesthetic drugs during operation was lower than that in the control group(P<0.05).Before surgery,there were no significant differences in hip function and kinesiophobia scores between the two groups(P>0.05);at 3 d after surgery,hip function scores in both group s were higher than those before surgery,and kinesiophobia scores were lower than those before surgery,and hip function score in observation group was higher than that in control group,kinesiophobia score was lower than that in control group(P<0.05).The recovery time,getting out of bed time,exercise time of affected limb and hospitalization time in observation group were shorter than those in control group(P<0.05).Before surgery,there was no significant difference in visual analog scale(VAS)score between the two groups(P>0.05);compared with preoperative results,VAS scores in both groups decreased 12,24 and 48 h after surgery,and those in observation group were

关 键 词：镇痛麻醉护理 腰骶丛神经阻滞 全麻 全髋关节置换术 

分 类 号：R473.6[医药卫生—护理学]