B超引导下腰丛-坐骨神经联合阻滞对股骨粗隆间骨折患者认知功能的影响  

The Effect of Combined Lumbar Plexus Sciatic Nerve Block Guided by B-Ultrasound on Cognitive Function in Patients with Intertrochanteric Fractures of the Femur

作　　者：张晓君 ZHANG Xiao-jun(Department of Anesthesiology,Donggang Central Hospital,Liaoning Donggang 118300)

机构地区：[1]东港市中心医院麻醉科,辽宁东港118300

出　　处：《中国医疗器械信息》2023年第10期39-41,共3页China Medical Device Information

摘　　要：目的:分析股骨粗隆间骨折疾病、手术麻醉特点,评价B超下腰丛-坐骨神经联合阻滞对患者认知功能等方面的影响。方法:选择2019年7月~2020年7月本院收治的股骨粗隆间骨折疾病患者120例,在人工股骨头置换术治疗基础上进行对照组、观察组随机法分组麻醉,各60例。对照组患者采取蛛网膜下腔阻滞复合硬膜外麻醉,观察组患者采取B超引导下腰丛-坐骨神经联合阻滞麻醉。比较2组股骨粗隆间骨折患者的术后不良反应发生情况以及认知功能评分、疼痛评分。以简易智力状态检查量表(mini-men-tal state examination,MMSE)以及视觉模拟评分法(Visual Analogue Scale/Score,VAS)评估。结果:组间术后恶心呕吐、尿潴留等术后不良反应发生情况比较,观察组患者总发生率10.00%明显低于对照组的25.00%,P<0.05;组间术后1d、3d、7dMMSE评分比较,观察组患者评分均明显高于对照组,P<0.05;组间术后6h、12h、24h、72hVAS评分比较,观察组患者评分均明显低于对照组,P<0.05。结论:股骨粗隆间骨折患者B超引导下腰丛-坐骨神经联合阻滞麻醉可以减少对患者认知功能的影响,减轻患者术后疼痛、减少术后不良反应,是有效麻醉方案。Objective:To analyze the characteristics of intertrochanteric fracture disease and surgical anesthesia,and to evaluate the effects of combined B-ultrasound lower lumbar plexus-sciatic nerve block on patients’cognitive function.Methods:Patients with intertrochanteric fracture disease(n=120)who were admitted to our hospital from July 2019 to July 2020 were selected.On the basis of artificial femoral head replacement treatment,the control group and the observation group were randomly divided into groups and anesthetized.60 cases.The patients in the control group were given subarachnoid block combined with epidural anesthesia,and the patients in the observation group were given the combined lumbar plexus-sciatic nerve block anesthesia guided by B-ultrasound.The incidence of adverse reactions,cognitive function scores and pain scores of patients with femoral intertrochanteric fractures were compared between the two groups.It was evaluated by the Mini-Men-tal State Examination(MMSE)and Visual Analogue Scale/Score(VAS).Results:The incidence of postoperative adverse reactions such as nausea,vomiting and urinary retention in the observation group was 10.00%lower than that in the control group(25.00%,P<0.05);The MMSE scores of the observation group were significantly higher than those of the control group on the 1st,3rd,and 7th day after surgery,P<0.05;Comparison of VAS scores between groups at 6h,12h,24h,and 72h after surgery showed that the scores of patients in the observation group were significantly lower than those in the control group(P<0.05).Conclusion:B-ultrasound guided lumbar plexus sciatic nerve block anesthesia can reduce the impact on cognitive function,alleviate postoperative pain,and reduce postoperative adverse reactions in patients with intertrochanteric fracture of the femur.It is an effective anesthesia plan.

关 键 词：B超引导 腰丛-坐骨神经联合阻滞 股骨粗隆间骨折 疼痛状况 认知功能 人工股骨头置换术 

分 类 号：R614[医药卫生—麻醉学]