连续髂筋膜间隙阻滞对老年髋部骨折患者心血管应激反应的影响  

Effect of Continuous Iliac Fascial Space Block on Cardiovascular Stress Response in Elderly Patients With Hip Fracture

作　　者：郑新牡 上官明化[1] 李舒雯 吴桂寿[1] ZHENG Xinmu;SHANGGUAN Minghua;LI Shuwen;WU Guishou(Department of Anesthesiology,Sanming Second Hospital,Sanming Fujian 366000,China)

机构地区：[1]三明市第二医院麻醉科,福建三明366000

出　　处：《中国卫生标准管理》2023年第24期87-90,共4页China Health Standard Management

摘　　要：目的探讨连续髂筋膜间隙阻滞对老年髋部骨折患者心血管应激反应的影响。方法回顾性分析2021年6月—2023年1月三明市第二医院收治的以老年髋部骨折为诊断的100例患者,根据镇痛方式的不同分为两组,其中对照组以常规术后静脉镇痛处置,研究组以连续髂筋膜间隙阻滞镇痛。比较两组患者在术前、术后不同时间静息、运动时疼痛评分,术前、术后应激反应指标,统计围手术期并发症发生情况。结果在术后6、24、48 h时,两组较术前静息、运动时疼痛评分均下降,且研究组低于对照组(P<0.05)。两组患者术后血糖、皮质醇、去甲肾上腺素、血管紧张素Ⅱ水平较术前下降,且研究组低于对照组(P<0.05)。研究组围手术期并发症总发生率低于对照组(P<0.05)。结论在老年髋部骨折患者中给予连续髂筋膜间隙阻滞,可显著减轻患者术后静息、运动时疼痛程度,降低术后应激指标,进而减少由于术后疼痛或由药物所产生的并发症,保障患者术后安全性。Objective To investigate the effect of continuous iliac fascial space block on cardiovascular stress response in elderly patients with hip fracture.Methods A retrospective analysis was performed on 100 elderly patients diagnosed with hip fracture admitted to Sanming Second Hospital from June 2021 to January 2023.The patients were divided into two groups according to different analgesia methods.The control group received routine postoperative intravenous analgesia,and the study group received continuous iliac fascia space block analgesia.The pain scores during rest and exercise,as well as stress response indicators before and after surgery,between two groups of patients at different time before and after surgery,and calculate the incidence of perioperative complications were compared.Results At 6,24 and 48 h after surgery,the pain scores of both groups were lower than those of the preoperative resting and exercise,and the study group was lower than the control group(P<0.05).The levels of blood glucose,cortisol,norepinephrine and angiotensinⅡin the two groups after surgery were lower than those before surgery,and the levels in the study group were lower than those in the control group(P<0.05).The total incidence of perioperative complications in study group was lower than that in control group(P<0.05).Conclusion Continuous iliac fascial space block in elderly patients with hip fracture can significantly reduce the degree of pain during rest and exercise,reduce postoperative stress indicators,and further reduce the complications caused by postoperative pain or drugs,and ensure postoperative safety.

关 键 词：连续髂筋膜间隙阻滞 髋部骨折 老年患者 术后镇痛 心血管应激 疼痛评分 

分 类 号：R714[医药卫生—妇产科学]