高龄髋部骨折患者在手术治疗中采用腰硬联合麻醉的镇痛效果评价  

Evaluation of Analgesic Effect of Spinal Epidural Anesthesia in Elderly Pa⁃tients with Hip Fracture

作　　者：杨艳华 YANG Yanhua(Department of Anesthesiology,Chifeng Tumor Hospital,Inner Mongolia Autonomous Region,024000 China)

机构地区：[1]内蒙古赤峰市肿瘤医院麻醉科,内蒙古赤峰024000

出　　处：《中外医疗》2023年第2期85-89,共5页China & Foreign Medical Treatment

摘　　要：目的评价在高龄髋部骨折患者的手术治疗中实施腰硬联合麻醉的镇痛效果。方法随机选取2018年1月—2022年1月内蒙古赤峰市肿瘤医院100例高龄髋部骨折病例作为研究对象。分组依据为麻醉方法,对照组(n=50)予以硬膜外麻醉。观察组(n=50)予以腰硬联合麻醉。对比两组患者镇痛效果、平均动脉压及心率测量值、麻醉相关时间值、不良反应发生情况、肌松效果、血清炎性因子水平检测结果。结果术后各个时间点,观察组的疼痛数字评分值均比对照组低,差异有统计学意义(P<0.05)。观察组的MAP、HR值均比对照组高,差异有统计学意义(P<0.05)。观察组的感觉神经阻滞和运动神经阻滞的起效时间均比对照组短,起效后维持时间均比对照组长,差异有统计学意义(P<0.05)。观察组的不良反应发生率为2.00%,比对照组的16.00%低,差异有统计学意义(χ^(2)=4.396,P=0.036)。观察组的肌松优良率比对照组高,差异有统计学意义(P<0.05)。观察组的IL-6、TNF-α、CRP水平检测结果均比对照组低,差异有统计学意义(P<0.05)。结论选择高龄髋部骨折患者,在其手术治疗中实施腰硬联合麻醉的效果显著,能够提高镇痛效果、肌松效果,缩短麻醉起效时间,增加麻醉维持时间,还能够降低不良反应的发生概率。Objective To evaluate the analgesic effect of spinal epidural anesthesia in the surgical treatment of elderly patients with hip fracture.Methods 100 elderly cases of hip fractures from Chifeng Cancer Hospital in Inner Mongolia from January 2018 to January 2022 were randomly selected as the research subjects.The grouping was based on differ⁃ences in anesthesia methods,while the control group(n=50)received epidural anesthesia.The observation group(n=50)received combined spinal epidural anesthesia.Compare the analgesic effects,mean arterial pressure and heart rate measurements,anesthesia related time values,statistics of adverse reactions,muscle relaxation effects,and serum in⁃flammatory factor levels between the two groups.Results At various postoperative time points,the pain numerical scores of the observation group were lower than those of the control group,and the difference was statistically signifi⁃cant(P<0.05).The MAP and HR values of the observation group were higher than those of the control group,and the difference was statistically significant(P<0.05).The onset time of sensory nerve block and motor nerve block in the ob⁃servation group was shorter than that in the control group,and the maintenance time after onset was longer than that in the control group,and the difference was statistically significant(P<0.05).The incidence of adverse reactions in the observation group was 2.00%,lower than the 16.00%in the control group,and the difference was statistically signifi⁃cant(χ^(2)=4.396,P=0.036).The excellent and good rate of muscle relaxation in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).IL-6 and TNF in the observation group-α、the CRP level test results were all lower than those of the control group,and the difference was statisti⁃cally significant(P<0.05).Conclusion Selecting elderly patients with hip fractures,combined spinal epidural anesthe⁃sia has a significant effect in the surgical treatment,which can improv

关 键 词：高龄髋部骨折患者 腰硬联合麻醉 镇痛效果 肌松效果 血清炎性因子 

分 类 号：R816.8[医药卫生—放射医学]