超声引导下腰骶丛神经阻滞联合全身麻醉对老年股骨头置换患者麻醉效果及术后认知功能的影响  

The Effect of Ultrasound-guided Lumbar Sacral Plexus Block Combined with General Anesthesia on Anesthesia Efficacy and Postoperative Cognitive Function in Elderly Patients Undergoing Femoral Head Replacement

作　　者：郑龙蛟 蒋伟 ZHENG Longjiao;JIANG Wei(Department of Anesthesiology,Wuxi Huishan District People's Hospital,Wuxi 214000,China;不详)

机构地区：[1]无锡市惠山区人民医院麻醉科,江苏无锡214000

出　　处：《中国医学创新》2025年第9期105-109,共5页Medical Innovation of China

基　　金：2022年度无锡市卫生健康委科研项目(面上项目)(M202213)。

摘　　要：目的:探讨超声引导下腰骶丛神经阻滞联合全身麻醉对老年股骨头置换患者麻醉效果及术后认知功能的影响。方法:回顾性分析2023年1月-2024年6月无锡市惠山区人民医院收治的老年股骨头置换患者103例,根据麻醉方法不同分为两组,对照组(n=51)采用全身麻醉,联合组(n=52)采用超声引导下腰骶丛神经阻滞联合全身麻醉。比较两组麻醉效果、围手术期血流动力学指标[心率(HR)、平均动脉压(MAP)、血氧饱和度(SpO_(2))]水平及简易智能精神状态评价量表(MMSE)评分,并记录两组并发症发生情况。结果:联合组麻醉效果优率(86.54%)高于对照组(70.59%),差异有统计学意义(P<0.05)。入室前,两组血流动力学指标MAP、HR、SpO_(2)水平比较,差异均无统计学意义(P>0.05);麻醉诱导即刻、麻醉诱导30 min及拔管即刻各时间点,两组MAP、HR、SpO_(2)水平与入室前相比均下降,但联合组麻醉诱导即刻、麻醉诱导30 min及拔管即刻各时间点MAP、HR、SpO_(2)水平均高于同期对照组,差异均有统计学意义(P<0.05)。术后1、3 d,两组MMSE评分均低于术前,但术后1、3 d,联合组MMSE评分与同期对照组相比均高,差异均有统计学意义(P<0.05)。联合组并发症发生率(3.85%)低于对照组(17.65%),差异有统计学意义(P<0.05)。结论:超声引导下腰骶丛神经阻滞联合全身麻醉能提高老年股骨头置换患者麻醉效果,维持血流动力学稳定,且对患者术后认知功能影响小,安全性良好。Objective:To investigate the effect of ultrasound-guided lumbar sacral plexus block combined with general anesthesia on the anesthesia efficacy and postoperative cognitive function of elderly patients undergoing femoral head replacement.Method:A retrospective analysis was conducted on 103 elderly patients undergoing femoral head replacement admitted to Wuxi Huishan District People's Hospital from January 2023 to June 2024.According to different anesthesia methods,they were divided into a control group(n=51)receiving general anesthesia,and a combination group(n=52)receiving ultrasound-guided lumbar sacral plexus block combined with general anesthesia.The anesthesia effects between two groups,perioperative hemodynamic indicators[heart rate(HR),mean arterial pressure(MAP),and blood oxygen saturation(SpO2)]levels,as well as scores of the Mini mental state examination(MMSE)were compared.The incidences of complications between the two groups were recorded.Result:The excellent rate of anesthesia effect in the combination group was 86.54%,which was higher than 70.59%in the control group,the difference was statistically significant(P<0.05).Before entering the room,there were no statistically significant differences in the levels of hemodynamic indicators(MAP,HR and SpO2)between the two groups of patients(P>0.05);at each time point of anesthesia induction,anesthesia induction 30 minutes,and extubation,the levels of MAP,HR and SpO2 in both groups of patients decreased compared to those before entering the room.However,the MAP,HR and SpO2 levels in the combination group were significantly higher than those in the control group at each time point of anesthesia induction,anesthesia induction 30 minutes,and extubation(P<0.05).On the 1 day and 3 days after operation,the MMSE scores of the two groups were lower than those before operation,but on the 1 day and 3 days after operation,the MMSE scores of the combination group were higher than those of the control group,the differences were statistically significant(P<0.05).The incide

关 键 词：老年股骨头置换术 超声引导 腰骶丛神经阻滞 全身麻醉 术后认知功能 

分 类 号：R61[医药卫生—外科学]