监测麻醉下局部软组织浸润麻醉在老年股骨粗隆间骨折患者手术中的应用效果  

The application effect of local soft tissue infiltration anesthesia under monitoring anesthesia in the surgery of elderly patients with intertrochanteric fractures of the femur

作　　者：齐文举 刘淑彬[1] 徐康[1] QI Wenju;LIU Shubin;XU Kang(Department of Surgical Anesthesia,Xintai People's Hospital,Shandong,Xintai,271200,China)

机构地区：[1]新泰市人民医院手术麻醉科,山东新泰271200

出　　处：《当代医学》2024年第15期25-29,共5页Contemporary Medicine

摘　　要：目的分析监测麻醉联合局部软组织浸润麻醉在老年股骨粗隆间骨折(ITF)患者手术中的应用效果。方法选取2020年6月至2022年6月新泰市人民医院收治的150例老年ITF患者作为研究对象,随机分为对照组与观察组,每组75例。两组患者均行防旋型股骨近端髓内针内固定手术治疗,对照组采用常规全身麻醉,观察组采用监测麻醉联合局部软组织浸润麻醉。比较两组麻醉效果、围手术期生命体征[心率(HR)、呼吸频率(RR)、血氧饱和度(SpO_(2))、血红蛋白(Hb)、呼气末二氧化碳分压(ETCO_(2))]、应激反应指标[白细胞介素-2(IL-2)、白细胞介素-1β(IL-1β)、超氧化物歧化酶(SOD)、丙二醛(MDA)]、数字疼痛分级法(NRS)评分及不良反应发生率。结果观察组液体输注量少于对照组,苏醒时间短于对照组,差异有统计学意义(P<0.05)。观察组最小HR快于对照组,术前术后Hb差值高于对照组,最大HR、最小RR均慢于对照组,ETCO_(2)低于对照组,差异有统计学意义(P<0.05);两组最大SpO_(2)水平比较差异无统计学意义。麻醉2 h后,观察组血清MDA、IL-2、IL-1β水平低于对照组,血清SOD水平高于对照组,差异有统计学意义(P<0.05)。术后12、24、48 h,观察组NRS评分均低于对照组,阿片类镇痛药使用量、对乙基苯酚使用量均少于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论监测麻醉下局部软组织浸润麻醉应用于老年ITF患者手术中,能维持患者生命体征稳定,减轻机体应激反应,缓解患者镇痛程度,减少并发症。Objective To analyze the application effect of monitoring anesthesia combined with local soft tissue infiltration anesthesia in the surgery of elderly patients with intertrochanteric fractures(ITF)of the femur.Methods 150 elderly ITF patients admitted to Xintai People's Hospital from June 2020 to June 2022 were selected as the research subjects,and they were randomly divided into the control group and the observation group,with 75 cases in each group.The patients in both groups were treated with anti-rotation type intramedullary pin internal fixation surgery of proximal femur,and the control group received conventional general anesthesia,while the observation group received monitoring anesthesia combined with local soft tissue infiltration anesthesia.The anesthesia effects,perioperative vital signs(heart rate[HR],respiratory rate[RR],blood oxygen saturation[SpO2],hemoglobin[Hb],end tidal carbon dioxide pressure[ETCO2]),stress response indicators(interleukin-2[IL-2],interleukin-1β[IL-1β],superoxide dismutase[SOD],malondialdehyde[MDA]),numerical rating scale(NRS)scores,and incidence of adverse reactions were compared between the two groups.Results The liquid infusion volume in the observation group was lower than that in the control group,and the recovery time was shorter than that in the control group,the difference was statistically significant(P<0.05).The minimum HR in the observation group was faster than that in the control group,the difference of Hb before and after surgery was higher than that in the control group,the maximum HR and minimum RR were slower than those in the control group,and the ETCO2 was lower than that in the control group,the differences were statistically significant(P<0.05);there was no statistically significant difference in the maximum SpO2 levels between the two groups.After 2 h of anesthesia,the levels of serum MDA,IL-2,and IL-1βin the observation group were lower than those in the control group,and the level of serum SOD was higher than that in the control group,the differences w

关 键 词：股骨粗隆间骨折 局部组织浸润麻醉 监测麻醉 炎症反应 并发症 疼痛分级 

分 类 号：R614[医药卫生—麻醉学]