B超引导下髋关节囊周神经丛阻滞与腹股沟上髂筋膜间隙阻滞在股骨颈骨折患者中的应用效果对比  

Comparison on the Application of Pericapsular Nerve Group Block and Supra-Inguinal Fascia Iliaca Compartment Block in Patients with Femoral Neck Fracture Under B-Ultrasound Guidance

作　　者：毕路甲[1] 杨利民[1] 朱建业 陈辉[1] 闫军杰[2] BI Lujia;YANG Limin;ZHU Jianye;CHEN Hui;YAN Junjie(Department of Anesthesiology,the Second Affiliated Hospital of Luohe Medical College,Luohe 462300,China;Department of Pediatrics,the Second Affiliated Hospital of Luohe Medical College,Luohe 462300,China)

机构地区：[1]漯河医学高等专科学校第二附属医院麻醉科,河南漯河462300 [2]漯河医学高等专科学校第二附属医院儿科,河南漯河462300

出　　处：《河南医学研究》2024年第21期3920-3924,共5页Henan Medical Research

摘　　要：目的探讨B超引导下髋关节囊周神经丛阻滞(PNGB)与腹股沟上髂筋膜间隙阻滞(S-FICB)在股骨颈骨折(FNF)患者中的应用效果。方法选取2021年9月至2022年9月在漯河医学高等专科学校第二附属医院就诊的80例行全髋节置换术治疗的FNF患者为研究对象,根据随机数表法分为S-FICB组与PNGB组,每组40例。S-FICB组行S-FICB阻滞,PNGB组行PNGB阻滞。记录患者阻滞前(T_(0))和阻滞后5 min(T_(1))、10 min(T_(2))、15 min(T_(3))时的心率。记录患者T_(0)、T_(3)及阻滞后30 min(T_(4))、2 h(T_(5))、6 h(T_(6))、12 h(T_(7))、24 h(T_(8))静息、抬髋15°时的数字评定量表(NRS)评分。记录患者超声成像时间、穿刺操作时间、超声成像清晰度评分、首次下床活动时间、住院时间、术后并发症发生情况。结果两组T_(0)~T_(3)时的心率组间、时间和交互作用无统计学意义(P>0.05)。两组静息时T_(0)、T_(3)~T_(8)时NRS评分的组间、时间和交互作用有统计学意义(P<0.05),PNGB组静息时T_(0)、T_(3)~T_(8)时NRS评分均低于S-FICB组(P<0.05)。两组抬髋15°时T_(0)、T_(3)~T_(8)的NRS评分的组间、时间和交互作用有统计学意义(P<0.05),且PNGB组抬髋15°时T_(0)、T_(3)~T_(8)的NRS评分均低于S-FICB组(P<0.05)。PNGB组超声成像时间短于S-FICB组(P<0.05);术后,PNGB组首次下床活动时间短于S-FICB组(P<0.05);两组均未见神经阻滞相关并发症。结论S-FICB和PNGB应用于FNF患者中,均有较好的镇痛效果,对心率无明显影响,但PNGB在缓解术后疼痛,缩短超声成像时间,促进术后恢复方面效果更佳。Objective To explore the application effect of pericapsular nerve group block(PNGB)and supra-inguinal fascia iliaca compartment block(S-FICB)in patients with femoral neck fracture(FNF)under B-ultrasound guidance.Methods A total of 80 patients with FNF undergoing total hip arthroplasty(THA)in the Second Affiliated Hospital of Luohe Medical College were enrolled as the research objects between September 2021 and September 2022.According to random number table method,they were divided into S-FICB group and PNGB group,40 cases in each group.Heart rate before block(T_(0)),at 5 minutes after block(T_(1)),10 minutes after block(T_(2))and 15 minutes after block(T_(3)).The scores of numeric rating scale(NRS)at T_(0),T_(3),30 minutes after block(T_(4)),2 hours after block(T_(5)),6 hours after block(T_(6)),12 hours after block(T_(7))and 24 hours after block(T_(8))under rest state and 15°hip lifting state.Ultrasound imaging time,puncture time,score of ultrasound imaging resolution,the first leaving bed time,hospitalization time and postoperative complications in both groups were recorded.Results There was no statistical difference in heart rate in terms of between-group,time points and interaction dimensions from T_(0)-T_(3)(P>0.05).At T_(0)and T_(3)-T_(8),there were statistical differences in NRS scores under rest state in terms of between-group,time points and interaction dimensions(P<0.05),and which were lower in PNGB group than S-FICB group(P<0.05).At T_(0)and T_(3)-T_(8),there were statistical differences in NRS scores under 15°hip lifting state in terms of between-group,time points and interaction dimensions(P<0.05),and which were lower in PNGB group than S-FICB group(P<0.05).The ultrasound imaging time in PNGB group was shorter than that in S-FICB group(P<0.05).After surgery,the first leaving bed time in PNGB group was shorter than that in S-FICB group(P<0.05).There were no complications related to nerve block in either group.Conclusion The effect of PNGB and S-FICB is similar on heart rate in FNF patients.However,t

关 键 词：B超引导 髋关节囊周神经丛阻滞 腹股沟上髂筋膜间隙阻滞 股骨颈骨折 

分 类 号：R445.1[医药卫生—影像医学与核医学]