超声引导下坐骨神经阻滞麻醉对足部手术患者下肢血流循环的影响  

Effect of Ultrasound-Guided Sciatic Nerve Block Anesthesia on Lower Limb Blood Circulation in Patients Undergoing Foot Surgery

作　　者：王兴华 杨彩平 WANG Xinghua;YANG Caiping(Department of Anesthesiology,Yangling Demonstration Zone Hospital,Xianyang Shaanxi 712100)

机构地区：[1]陕西省杨凌示范区医院麻醉科,陕西咸阳712100 [2]陕西省榆林市府谷县人民医院麻醉科,陕西榆林719400

出　　处：《医学临床研究》2024年第11期1729-1732,共4页Journal of Clinical Research

摘　　要：【目的】探讨超声引导下坐骨神经阻滞麻醉对足部手术患者下肢血流循环的影响。【方法】在两院行足部手术的78例患者,随机分为观察组和对照组,每组39例。比较两组患者的麻醉效果及相关指标;比较两组患者麻醉前(T_(0))、麻醉后30 min(T_(1))、手术结束时(T_(2))的血流动力学指标[心率(HR)、平均动脉压(MAP)];比较两组患者手术前后凝血功能指标[凝血酶时间(TT)、凝血酶原时间(PT)、活化部分凝血酶时间(APTT)]水平;比较两组患者不良反应发生情况。【结果】观察组运动、感觉阻滞持续时间均长于对照组,排尿恢复时间、下肢运动恢复时间均短于对照组,且差异均有统计学意义(P<0.05)。对照组在T_(1)时的HR、MAP及T_(2)时的MAP均低于同组T_(0)时(P<0.05);观察组T_(1)时HR、MAP及T_(2)时MAP均高于对照组同时点(P<0.05)。两组患者术后TT、PT、APTT均长于同组术前(P<0.05),且观察组术后TT、PT、APTT均显著长于对照组术后(P<0.05)。观察组麻醉优良率(97.44%)明显高于对照组(79.49%)(P<0.05)。观察组不良反应总发生率(7.69%)明显低于对照组(25.64%)(P<0.05)。【结论】超声引导下坐骨神经阻滞用于足部手术中的麻醉效果好,可有效改善患者凝血功能指标,且不良反应发生率低,安全性较高。【Objective】To investigate the impact of ultrasound-guided sciatic nerve block anesthesia on lower limb blood circulation in patients undergoing foot surgery.【Methods】A total of 78 patients undergoing foot surgery from our two hospitals were randomly divided into the observation group and the control group,with 39 patients in each group.The anesthetic effects and related indicators were compared between the two groups.Hemodynamic parameters such as heart rate(HR)and mean arterial pressure(MAP)were measured before anesthesia(T_(0)),30 minutes after anesthesia(T_(1)),and at the end of the surgery(T_(2)).Coagulation function indices,including thrombin time(TT),prothrombin time(PT),and activated partial thromboplastin time(APTT),were compared before and after surgery.The incidence of adverse reactions was also compared between the two groups.【Results】The duration of motor and sensory block in the observation group was significantly longer than that in the control group,while the time to urination and lower limb motor recovery of the observation group was shorter than of in the control group,with statistically significant differences(P<0.05).In the control group,HR and MAP at T_(1)and MAP at T_(2)were lower than those at T_(0)(P<0.05).HR and MAP at T_(1)and MAP at T_(2)in the observation group were higher than those in the control group at the same time points(P<0.05).Postoperative levels of TT,PT,and APTT were higher than preoperative levels in both groups(P<0.05),and postoperative TT,PT,and APTT levels in the observation group were significantly higher than those in the control group(P<0.05).The excellent rate of anesthesia in the observation group(97.44%)was significantly higher than in the control group(79.49%)(P<0.05).The total incidence of adverse reactions in the observation group was 7.69%,which was significantly lower than that in the control group(25.64%)(P<0.05).【Conclusion】Ultrasound-guided sciatic nerve block anesthesia for foot surgery has excellent anesthetic effects and safe clinical app

关 键 词：足/外科学 超声检查 神经传导阻滞/方法 坐骨神经 血液循环 

分 类 号：R68[医药卫生—骨科学]