超声引导下股神经阻滞复合全身麻醉在小儿股骨干骨折手术中的应用效果分析  

Application of Ultrasound-guided Femoral Nerve Block Combined with Genera Anesthesia in the Operation of Femoral Shaft Fracture in Children

作　　者：蔡燕妮 CAI Yanni(Department of anesthesiology,Dalian women and children medical center(Group),Dalian,Liaoning 116021)

机构地区：[1]大连市妇女儿童医疗中心(集团)麻醉科,辽宁大连116021

出　　处：《中国伤残医学》2023年第12期22-26,共5页Chinese Journal of Trauma and Disability Medicine

摘　　要：探究分析超声引导下股神经阻滞复合全身麻醉在小儿股骨干骨折手术中的应用效果。方法:将我院2020年1月—12月收治的80例小儿股骨干骨折患者视为观察对象并纳入本研究,所有患儿均行手术治疗。此外,将入组患儿依照随机数字表法(由计算机随机生成数字1—80号)分成2组,对照组和观察组,各40例。其中,对照组患儿均制定并执行常规全麻,观察组患儿均制定并执行超声引导下股神经阻滞复合全身麻醉,对比2种不同麻醉方式对应患儿的麻醉效果(不同手术阶段的生命体征、相关手术临床指标以及不良反应)。结果:(1)观察组患儿经过麻醉后,其MAP(t切皮=25.982、t复位=26.418、t术后=16.845)、HR(t切皮=43.461、t复位=49.177、t术后=21.769)等生命体征在不同手术阶段的水平均比对照组更为稳定,数据对比,P<0.05,有统计学意义;(2)观察组患儿的相关手术临床指标(t舒芬太尼用量=2.946、t拔管时间=12.531、t唤醒时间=10.071、t术后疼痛评分=6.081、3.832)优于对照组,数据对比,P<0.05,有统计学意义;(3)2组患儿穿刺时皆无误入肠腔的案例,分别出现误入血管和误入胸膜2种不良反应,而在术后均发生了不同程度的不良反应,观察组的不良反应率为5.00%,远低于对照组的15.00%(x2=5.556),数据对比,P<0.05,有统计学意义;(4)观察组患者的治疗总有效率高于对照组(x2=5.556),家属对治疗的总满意度也高于对照组(x2=12.500),数据对比,P<0.05,有统计学意义。结论:在小儿股骨干骨折手术中采用超声引导下股神经阻滞复合全身麻醉有助于稳定其生命体征,减少镇痛药用量,促进患儿苏醒,还有助于降低其不良反应风险,缓解术后疼痛,加快患儿康复进程。Objective:To explore and analyze the effect of ultrasound-guided femoral nerve block combined with general anesthesia in the operation of femoral shaft fracture in children.Methods:80 children with femoral shaft fracture treated in our hospital from January to December 2020 were regarded as observation objects and included in the study.All children were treated with surgery.In addition,the enrolled children were divided into two groups according to the random number table method(numbers 1-80 randomly generated by the computer).Both the control group and the observation group were divided into 40 cases.Among them,the children in the control group developed and implemented conventional general anesthesia,and the children in the observation group developed and implemented ultrasound-guided femoral nerve block combined general anesthesia,and compared the anesthesia effects of the two different anesthesia methods(vital signs,relevant clinical indicators and adverse reactions in different operation stages).Results:(1)after anesthesia,the levels of vital signs in the observation group were more stable than those in the control group(P<0.05);(2)The clinical indexes of the observation group(t sufentanil dosage=2.946,t extubation time=12.531,t wake-up time=10.071,t postoperative pain score=6.081,3.832)were better than those of the control group(P<0.05);(3)There were no cases of entering intestinal cavity by mistake during puncture in the two groups.There were two kinds of adverse reactions,i.e.entering blood vessel by mistake and entering pleura by mistake.However,adverse reactions occurred in different degrees after operation.The adverse reaction rate in the observation group was 5.00%,far lower than that in the control group of 15.00%(x2=5.556),P<0.05,statistically significant;(4)The total effective rate of the observation group was higher than that of the control group(x2=5.556),and the total satisfaction of family members with treatment was also higher than that of the control group(x-12.500),P<0.05,statistically signi

关 键 词：小儿股骨干骨折 超声引导下股神经阻滞复合全身麻醉 手术 麻醉效果 

分 类 号：R614[医药卫生—麻醉学]