髂筋膜间隙阻滞持续镇痛对老年髋部骨折患者术后疼痛及早期康复影响  

Effect of continuous analgesia with iliofascial space block on postoperative pain and early recovery in elderly patients with hip fracture

作　　者：许旭霞 刘浩宇[1] 康翠芸 XU Xuxia;LIU Haoyu;KANG Cuiyun(Department of Anesthesiology,Luliang People's Hospital,Luliang 033099,Shanxi Province,China)

机构地区：[1]吕梁市人民医院麻醉科,山西吕梁033099

出　　处：《世界临床药物》2023年第5期488-492,共5页World Clinical Drug

摘　　要：目的探讨髂筋膜间隙阻滞(fascia iliaca compartment block,FICB)持续镇痛对老年髋部骨折术后疼痛及早期康复影响。方法选择2017年8月至2019年8月于吕梁市人民医院麻醉科接受手术治疗的髋部骨折老年患者103例,采用随机数表法分为观察组(n=52)和对照组(n=51)。两组均给予全身麻醉,对照组给予术后静脉镇痛,观察组给予FICB持续镇痛。比较两组不同时间点视觉模拟评分(visual analogue scale,VAS)、血清皮质醇(cortisol,Cor)、血管紧张素(angiotensin,Ang)Ⅱ、日常生活活动能力(activities of daily living,ADL)、Harris髋关节评分量表评分及并发症发生情况。结果观察组总优良率高于对照组(94.23%vs 80.39%,P<0.05);术后4 h及12 h,两组VAS评分均随时间推移而升高,且观察组低于对照组(P<0.05);术后24及48 h两组VAS评分均随时间推移而降低,且观察组低于对照组(P<0.05)。术后两组Cor、AngⅡ水平均随时间推移而下降,且观察组低于对照组(P<0.05)。术后30 d,两组ADL、Harris评分水平均随时间推移而升高,且观察组高于对照组(P<0.05)。观察组住院时间短于对照组,差异有统计学意义(P<0.05)。观察组并发症总发生率低于对照组(7.69%vs 25.49%,P<0.05)。结论在老年髋部骨折患者中应用FICB持续镇痛,可帮助促进术后康复,有效改善术后疼痛,且并发症较少。Objective To explore the influence of continuous analgesia with fascia iliaca compartment block(FICB)on postoperative pain and early rehabilitation after hip fracture surgery in the elderly.Methods A total of 103 elderly patients with hip fracture underwent surgical treatment in the Department of Anesthesiology,Luliang People's Hospital from August 2017 to August 2019 were selected and divided into observation group(n=52)and control group(n=51)by random number table method.Both groups were given general anesthesia,the control group was given postoperative intravenous analgesia,and the observation group was given FICB continuous analgesia.The visual analogue scale(VAS),serum cortisol(Cor),angiotensin(Ang)Ⅱ,activities of daily living(ADL)and Harris hip rating scale and complications were compared between the two groups at different time points.Results The total excellent and good rate of the observation group was 94.23%,which was higher than that of the control group 80.39%(P<0.05).At 4 h and 12 h after surgery,VAS scores in both groups increased with time,and the observation group was lower than those of the control group(P<0.05).At 24 h and 48 h after surgery,VAS scores of both groups were decreased with time,and the observation group was lower than those of the control group(P<0.05).After surgery,the levels of Cor and AngⅡin both groups were decreased with time,and the observation group were lower than those of the control group(P<0.05).Thirty days after surgery,ADL and Harris scores of both groups were increased with time,and the observation group were higher than those of the control group(P<0.05).The hospitalization time of the observation group was shorter than that in the control group,and the difference was significant(P<0.05).The total incidence of complications in the observation group was lower than that in the control group(7.69%vs 25.49%,P<0.05).Conclusion The application of FICB for continuous analgesia in elderly patients with hip fracture can help promote postoperative rehabilitation and effect

关 键 词：髂筋膜间隙阻滞 持续镇痛 老年髋部骨折 术后康复 

分 类 号：R614[医药卫生—麻醉学] R683.4[医药卫生—外科学]