区域神经阻滞麻醉对股骨粗隆间骨折手术患者疼痛及并发症的影响  

The effect of regional nerve block anesthesia on pain and complications in patients undergoing surgery for intertrochanteric fractures of the femur

作　　者：杨自娟 王冰[1] 丘宇[1] YANG Zijuan;WANG Bing;QIU Yu(Department of Anesthesiology,Guangdong North People's Hospital,Shaoguan,Guangdong,510026,China)

机构地区：[1]粤北人民医院麻醉科,广东韶关510026

出　　处：《当代医学》2024年第9期6-11,共6页Contemporary Medicine

摘　　要：目的探究区域神经阻滞麻醉对股骨粗隆间骨折手术患者疼痛及并发症的影响。方法选取2020年1月至2021年12月粤北人民医院收治的80例股骨粗隆间骨折患者作为研究对象,随机分为A组与B组,每组40例。A组实施全身麻醉,B组全身麻醉联合区域神经阻滞麻醉,比较两组血流动力学指标[心率(HR)、平均动脉压(MAP)]、疼痛程度[视觉模拟评分法(VAS)]、认知功能[简易精神状态量表(MMSE)]、血清学指标[神经生长因子-β(NGF-β)、髓鞘碱性蛋白(MBP)]及并发症发生情况。结果切皮、术毕时,B组HR慢于A组,MAP均低于A组,差异有统计学意义(P<0.05)。术后6、12、24h,B组VAS评分均低于A组,差异有统计学意义(P<0.05)。术后1、3d,B组MMSE评分均高于A组,差异有统计学意义(P<0.05)。术后1、3 d,B组NGF-β水平均高于A组,MBP水平均低于A组,差异有统计学意义(P<0.05)。B组并发症发生率为2.50%,低于A组的15.00%,差异有统计学意义(P<0.05)。结论对股骨粗隆间骨折手术患者实施全身麻醉联合区域神经阻滞麻醉,可保持其血流动力学稳定性,降低其术后疼痛感受,改善其术后认知功能,并降低并发症发生率。Objective To investigate the effect of regional nerve block anesthesia on pain and complications in patients undergoing intertrochanteric fractures of the femur.Methods 80 patients with intertrochanteric fractures of the femur admitted to Guangdong North Hospital from January 2020 to December 2021 were selected as the research subjects,and they were randomly divided into the group A and the group B,with 40 cases in each group.The group A received general anesthesia,while group B received general anesthesia combined with regional nerve block anesthesia.The hemodynamic indicators(heart rate[HR],mean arterial pressure[MAP]),pain level(visual analogue scale[VAS]),cognitive function(mini mental state examination[MMSE]),serum indicators(nerve growth factor-β[NGF-β],myelin basic protein[MBP]),and incidence of complications were compared between the two groups.Results At the time of skin incision and postoperative completion,the HR in the group B were slower than that in the group A,and the MAP were lower than that in the group A,and the differences were statistically significant(P<0.05).At 6,12,and 24 h after surgery,the VAS score in the group B were lower than that in the group A,and the differences were statistically significant(P<0.05).At 1 and 3 d after surgery,the MMSE scores in the group B were higher than those in the group A,and the difference was statistically significant(P<0.05).1 and 3 d after surgery,the average NGF-βlevel in the group B were higher than that in the group A,and the MBP level were lower than that in the group A,and the differences were statistically significant(P<0.05).The incidence of complications in the group B was 2.50%,which was lower than 15.00%in the group A,and the difference was statistically significant(P<0.05).Conclusion General anesthesia combined with regional nerve block anesthesia can maintain hemodynamic stability,reduce postoperative pain,improve postoperative cognitive function,and reduce the incidence of complications in patients undergoing surgery for intertrochanteric

关 键 词：股骨粗隆间骨折 区域神经阻滞麻醉 疼痛 

分 类 号：R614[医药卫生—麻醉学]