超声引导下腰丛坐骨神经阻滞麻醉在老年胫骨平台骨折患者中的应用  

Application of Ultrasound-guided Lumbar Plexus Sciatic Nerve Block Anesthesia in Elderly Patients with Tibial Plateau Fractures

作　　者：张萌 ZHANG Meng(Dingtao District People's Hospital,Heze City,Heze 274100,China)

机构地区：[1]菏泽市定陶区人民医院,山东菏泽274100

出　　处：《中外医学研究》2025年第1期33-36,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:分析超声引导下腰丛坐骨神经阻滞麻醉在老年胫骨平台骨折患者中的应用。方法:选取2021年7月—2023年7月菏泽市定陶区人民医院诊治的80例胫骨平台骨折老年患者为研究对象,采用随机数表法将其分为对照组40例,观察组40例,对照组采用全身麻醉,观察组采用超声引导下腰丛坐骨神经阻滞麻醉。对比两组围手术期动脉血氧分压(PaO_(2))、舒张压(DBP)、收缩压(SBP)、心率(HR)、应激反应[皮质醇(Cor)、去甲肾上腺素(NE)、肾上腺素(E)]、认知功能及术后不良反应发生情况。结果:两组麻醉前PaO_(2)、DBP、SBP、HR比较,差异无统计学意义(P>0.05);麻醉后15 min、麻醉后45 min、手术结束即刻,观察组PaO_(2)、DBP、SBP、HR均较对照组高,差异有统计学意义(P<0.05)。两组手术结束即刻应激反应指标比较,差异无统计学意义(P>0.05);两组术后2 h Cor、NE、E较手术结束即刻下降,但观察组术后2 h Cor、NE、E较对照组低,差异有统计学意义(P<0.05)。观察组术后1 d认知功能评分优于对照组,差异有统计学意义(P<0.05);观察组术后不良反应发生率明显低于对照组,差异有统计学意义(P<0.05)。结论:超声引导下腰丛坐骨神经阻滞麻醉相较于全身麻醉,不仅能够为老年胫骨平台骨折患者提供更加稳定的手术条件,还能减轻生理应激反应,同时对老年患者的认知功能影响更小,能降低术后不良反应发生风险。Objective:To analyze the application of ultrasound-guided lumbar plexus sciatic nerve block anesthesia in elderly patients with tibial plateau fractures.Method:A total of 80 elderly patients with tibial plateau fracture diagnosed and treated in Dingtao District People's Hospital,Heze City from July 2021 to July 2023 were selected as the study objects,and they were divided into control group 40 cases and observation group 40 cases by random number table method.The control group was given general anesthesia,and the observation group was given ultrasound-guided lumbar plexus sciatic nerve block anesthesia.Perioperative arterial partial oxygen pressure(PaO_(2)),diastolic blood pressure(DBP),systolic blood pressure(SBP),heart rate(HR),stress response[cortisol(Cor),norepinephrine(NE),epinephrine(E)],cognitive function and postoperative adverse reactions were compared between the two groups.Result:There were no significant differences in PaO_(2),DBP,SBP and HR between the two groups before anesthesia(P>0.05).PaO_(2),DBP,SBP and HR in the observation group were higher than those in the control group at 15 min after anesthesia,45 min after anesthesia and immediately after surgery,and the differences were statistically significant(P<0.05).There was no significant difference in stress response index between the two groups immediately after surgery(P>0.05).Cor,NE and E at 2 h after surgery of the two groups were lower than those immediately after surgery,but the Cor,NE and E of the observation group were lower than those of the control group at 2 h after surgery,and the differences were statistically significant(P<0.05).The cognitive function score of the observation group was better than that of the control group at 1 d after surgery,and the differences were statistically significant(P<0.05).The incidence of postoperative adverse reactions in the observation group was significantly lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion:Compared with general anesthesia,ultrasound

关 键 词：超声引导下腰丛坐骨神经阻滞麻醉 老年胫骨平台骨折 应激反应 认知功能 术后不良反应 

分 类 号：R614[医药卫生—麻醉学]