超声引导下股-腘窝坐骨神经阻滞在老年高血压患者单侧大隐静脉曲张手术中的应用  

Application of Ultrasound-guided Femoral-popliteal Fossa Sciatic Nerve Block in Operation of Unilateral Great Saphenous Vein Varicosis in Senile Patients with Hypertension

作　　者：吕爱萍 LYU Aiping(The Second Hospital of Longyan,Fujian Province,Longyan 364000,China)

机构地区：[1]福建省龙岩市第二医院,福建龙岩364000

出　　处：《中国医学创新》2023年第21期52-56,共5页Medical Innovation of China

摘　　要：目的:探讨超声引导下股-腘窝坐骨神经阻滞在老年高血压患者单侧大隐静脉曲张手术中的应用。方法:选取龙岩市第二医院2021年1月—2022年12月收治的66例大隐静脉曲张合并高血压的老年患者作为研究对象,根据随机数字表法进行分组,分为参照组、研究组,各33例。参照组实施蛛网膜下腔麻醉,研究组实施超声引导下股-腘窝坐骨神经阻滞麻醉。对比两组不同时间点血流动力学、感觉阻滞起效时间及维持时间、麻黄碱使用情况、术后并发症发生情况。结果:两组T_(0)、T_(2)时间点的舒张压、收缩压、平均动脉压及T_(0)、T_(1)、T_(2)时间点的心率比较,差异均无统计学意义(P>0.05);T_(1)时间点,研究组舒张压、收缩压、平均动脉压均高于参照组(P<0.05)。两组感觉阻滞起效时间比较,差异无统计学意义(P>0.05);研究组感觉阻滞维持时间长于参照组(P<0.05)。研究组麻黄碱使用率、术后并发症发生率均较参照组低(P<0.05)。结论:在单侧大隐静脉曲张手术中实施超声引导下股-腘窝坐骨神经阻滞麻醉,可取得更为理想的阻滞麻醉效果,能在减少对患者血流动力学影响的同时,延长阻滞维持时间,并减少麻黄碱使用和相关并发症发生。Objective:To investigate the application of ultrasound-guided femoral-popliteal fossa sciatic nerve block in operation of unilateral great saphenous vein varicosis in senile patients with hypertension.Method:A total of 66 senile patients with great saphenous vein varicosis complicated with hypertension in the Second Hospital of Longyan from January 2021 to December 2022 were selected as the research object,and they were divided into reference group and research group according to random number table method,with 33 cases in each group.The reference group was given spinal anesthesia,and the research group was given ultrasound-guided femoralpopliteal fossa sciatic nerve block anesthesia.The hemodynamics,onset time and maintenance time of sensory block,Ephedrine usage and postoperative complications were compared between the two groups at different time points.Result:There were no significant differences in diastolic pressure,systolic pressure,mean arterial pressure at T_(0),T_(1) time point,and heart rate at T_(0),T_(1) and T_(2) time point between the two groups(P>0.05).At T_(1) time point,the diastolic pressure,systolic pressure,mean arterial pressure in the research group were higher than those in the reference group(P<0.05).There was no significant difference in onset time of sensory block between the two groups(P>0.05).The maintenance time of sensory block in the research group was longer than that in the control group(P<0.05).The rates of Ephedrine usage and postoperative complications in the research group were lower than those in the reference group(P<0.05).Conclusion:Ultrasound-guided femoral-popliteal fossa sciatic nerve block in unilateral great saphenous vein varicosis operation can achieve a more ideal block anesthesia effect,which can reduce the impact on the hemodynamics of patients,extend the maintenance time of block,and reduce the Ephedrine usage and related complications.

关 键 词：大隐静脉曲张 高血压 股-腘窝坐骨神经阻滞 蛛网膜下腔麻醉 麻醉效果 

分 类 号：R614[医药卫生—麻醉学]