超声引导下股神经联合坐骨神经阻滞麻醉对老年下肢骨折患者的麻醉效果及安全性分析  

Effect and Security Analysis of Femoral Nerve Combined with Sciatic Nerve Block Anesthesia under Ultrasound Guidance on Elderly Patients withLower Limb Fracture

作　　者：王传芹 WANG Chuanqin(Department of Anesthesiology,Shanxian Hospital of Traditional Chinese Medicine,Heze 274300,China)

机构地区：[1]山东省单县中医医院麻醉科,山东菏泽274300

出　　处：《中国伤残医学》2024年第15期86-88,92,共4页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:探讨超声引导下股神经联合坐骨神经阻滞麻醉对老年下肢骨折患者的麻醉效果及安全性。方法:选取2022年1月—2024年4月单县中医医院收治的117例老年下肢骨折患者作为研究对象,根据随机数字表法分为对照组(n=58)和研究组(n=59)。对照组采用腰硬联合麻醉,研究组采用超声引导辅助下股神经联合坐骨神经阻滞麻醉。比较两组苏醒恢复情况、应激指标水平及并发症发生情况。结果:术后即刻,两组瑞姆赛镇静(Ramsay)评分比较,差异无统计学意义(P>0.05);术后5、10、30 min,研究组Ramsay评分均低于对照组,差异均有统计学意义(P<0.05)。术后第1天,两组皮质醇、肾上腺素和去甲肾上腺素水平均高于术前,但研究组低于对照组,差异均有统计学意义(P<0.05)。研究组并发症发生率3.39%低于对照组的13.79%,差异有统计学意义(P<0.05)。结论:超声引导下股神经联合坐骨神经阻滞麻醉,有助于改善麻醉效果,减少应激反应和并发症。Objective:To investigate the efficacy and safety of ultrasound-guided femoral nerve combined with sciatic nerve block anesthesia in elderly patients with lower extremity fracture.Methods:A total of 117 elderly patients with lower limb fracture admitted to Shanxian Hospital of Traditional Chinese Medicine from January 2022 to April 2024 were selected as research objects,and divided into a control group(n=58)and a study group(n=59)according to random number table method.The control group was given lumbo-epidural anesthesia,and the study group was given femoral nerve combined with sciatic nerve block anesthesia assisted by ultrasound guidance.The recovery condition,stress index level and complications were compared between the two groups.Results:Immediately after surgery,there was no significant difference in the score of Ramsay sedation Sacale(Ramsay)between the two groups(P>0.05).At 5,10 and 30 min after operation,the Ramsay score of the study group were lower than those of the control group,and the differences were statistically significant(P<0.05).On the first day after surgery,the levels of cortisol,epinephrine and norepinephrine in the two groups were higher than those before surgery,but the study group were lower than the control group,with statistical significance(P<0.05).The complication rate of the study group was 3.39%,lower than 13.79%of the control group,the difference was statistically significant(P<0.05).Conclusion:Ultrasound-guided femoral nerve combined with sciatic nerve block anesthesia is helpful to improve the anesthetic effect,reduce the stress reaction and complications.

关 键 词：老年下肢骨折 超声引导 股神经 坐骨神经 阻滞麻醉 麻醉安全性 应激反应 

分 类 号：R683[医药卫生—骨科学]