腰硬联合阻滞与超声下腰丛神经阻滞方式用于股骨转子间骨折患者的麻醉效果及安全性对比研究  

Comparative study on the Anesthesia Effect and Safety of Combined Spinal Epidural Block and Ultrasound Guided Lumbar Plexus Block for Patients with Intertrochanteric Fractures of the Femur

作　　者：王洪阳[1] WANG Hongyang(Neijiang Hospital of Traditional Chinese Medicine,Neijiang 641003,China)

机构地区：[1]内江市中医医院,四川内江641003

出　　处：《中外医学研究》2023年第15期52-55,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:对比股骨转子间骨折患者予以腰硬联合阻滞、超声下腰丛神经阻滞的麻醉效果及安全性。方法:选择2020年2月─2022年2月于内江市中医医院行手术治疗的76例股骨转子间骨折患者为研究对象,采用随机数表法将其分为甲组(n=38)和乙组(n=38)。甲组采用腰硬联合阻滞麻醉,乙组采用超声下腰丛神经阻滞麻醉。观察两组麻醉效果、术后疼痛评分、麻醉不同时间点心率及平均动脉压、不良反应发生情况。结果:乙组麻醉总优良率明显高于甲组,差异有统计学意义(P<0.05)。乙组术后3 h、6 h及12 h的视觉模拟评分法(VAS)评分均明显低于甲组,差异有统计学意义(P<0.05)。乙组麻醉后5 min(T_(2))、麻醉后30 min(T_(3))的心率明显低于甲组,平均动脉压明显高于甲组,差异有统计学意义(P<0.05)。乙组不良反应发生率低于甲组,差异有统计学意义(P<0.05)。结论:超声下腰丛神经阻滞在股骨转子间骨折手术患者中的麻醉效果优于腰硬联合阻滞,镇痛效果更持久,且对心率及平均动脉压的影响相对较小,不良反应少,安全性更高。Objective:To compare the anesthesia effects and safety of combined spinal epidural block and lumbar plexus block under ultrasound in patients with intertrochanteric fractures of the femur.Method:A total of 76 patients with intertrochanteric fractures of the femur who underwent surgical treatment at Neijiang Hospital of Traditional Chinese Medicine from February 2020 to February 2022 were selected as the research subjects.They were randomly divided into group A(n=38)and group B(n=38)by a random number table method.Group A received combined spinal epidural block anesthesia,while group B received lumbar plexus block anesthesia under ultrasound.The anesthesia effect,postoperative pain score,heart rate and mean arterial pressure at different time points of anesthesia,occurrence of adverse reactions were observed in the two groups.Result:The overall excellent and good rate of anesthesia in group B was significantly higher than that in group A,the difference was statistically significant(P<0.05).Visual analog scale(VAS)scores in group B at 3 h,6 h and 12 h after surgery were significantly lower than those in group A,the differences were statistically significant(P<0.05).The heart rate of 5 min after anesthesia(T_(2))and 30 min after anesthesia(T_(3))in group B were significantly lower than those in group A,and the mean arterial pressure were significantly higher than those in group A,the differences were statistically significant(P<0.05).The incidence of adverse reactions in group B was lower than that in group A,the difference was statistically significant(P<0.05).Conclusion:The anesthesia effect of lumbar plexus block under ultrasound in patients undergoing surgery for intertrochanteric fracture of femur is better than that of combined spinal epidural block anesthesia,the analgesic effect is more lasting,and the effect on heart rate and average arterial pressure is relatively small,with fewer adverse reactions and higher safety.

关 键 词：腰硬联合阻滞 超声下腰丛神经阻滞 股骨转子间骨折 麻醉效果 安全性 

分 类 号：R614[医药卫生—麻醉学]