超声引导下髂筋膜神经阻滞联合全身麻醉在老年股骨近端骨折患者中的应用  

Application of Ultrasound-guided Iliac Fascia Nerve Block Combined with General Anesthesia in Elderly Patients with Proximal Femoral Fracture

作　　者：王飞 王胜 杨田 WANG Fei;WANG Sheng;YANG Tian(Department of Anesthesiology,Pizhou People's Hospital,Pizhou 221300,Jiangsu,China)

机构地区：[1]邳州市人民医院麻醉科,江苏邳州221300

出　　处：《世界复合医学(中英文)》2025年第3期120-123,128,共5页World Journal of Complex Medicine

摘　　要：目的 分析超声引导下髂筋膜神经阻滞联合全身麻醉治疗老年患者股骨近端骨折效果。方法 选取2023年1—9月邳州市人民医院手术治疗的100例老年股骨近端骨折患者,根据麻醉方法差异分为观察组(超声引导下髂筋膜神经阻滞联合全身麻醉)与对照组(全身麻醉),各50例。对比两组丙泊酚用量、苏醒时间、拔管时间、心率、平均动脉压、应激反应、认知功能。结果 丙泊酚使用剂量比较,观察组低于对照组[(184.58±16.27)mg vs (315.64±20.68)mg],差异有统计学意义(t=35.219,P<0.05)。相较于对照组,观察组苏醒时间与拔管时间更短,差异均有统计学意义(P均<0.05)。切皮时、手术开始30 min、术毕时,相较于观察组,对照组心率、平均动脉压水平更高,差异均有统计学意义(P均<0.05)。术毕时、术毕30 min,相较于对照组,观察组血清皮质醇、血管紧张素Ⅱ水平均更低,差异均有统计学意义(P均<0.05)。术后3 h、6 h,观察组认知功能评分更高,差异均有统计学意义(P均<0.05)。结论 全身麻醉与超声引导下髂筋膜神经阻滞联用可稳定老年股骨近端骨折患者机体血流动力学,缩短苏醒时间,可减轻患者术后应激反应与认知功能的影响。Objective To analyze the effect of iliac fascia nerve block under ultrasound guidance combined with general anesthesia in the treatment of elderly patients with proximal femoral fractures.Methods A total of 100 elderly patients with proximal femoral fractures who underwent surgical treatment in Pizhou People's Hospital from January to September 2023 were selected.According to the differences in anesthesia methods,they were divided into the observation group(iliac fascia nerve block under ultrasound guidance combined with general anesthesia) and the control group(general anesthesia),with 50 cases in each group.The propofol dosage,awakening time,extubation time,heart rate,mean arterial pressure,stress response and cognitive function were compared between the two groups.ResultsI n terms of the dosage of propofol used,the observation group was lower than the control group [(184.58±16.27) mg vs(315.64±20.68) mg],and the difference was statistically significant(t=35.219,P<0.05).Compared with the control group,the awakening time and extubation time of the observation group were shorter,and the differences were statistically significant(both P<0.05).At the time of skin incision,30 minutes after the start of the operation,and at the end of the operation,compared with the observation group,the heart rate and mean arterial pressure levels of the control group were higher,and the differences were statistically significant(all P<0.05).At the end of the operation and 30 minutes after the end of the operation,compared with the control group,the levels of serum cortisol and angiotensin Ⅱ in the observation group were lower,and the differences were statistically significant(both P<0.05).At 3 h and 6 h after operation,the cognitive function scores of the observation group were higher,and the difference was statistically significant(P<0.05).Conclusion The combination of general anesthesia and iliac fascia nerve block under ultrasound guidance can stabilize the hemodynamics of elderly patients with proximal femoral fractures,sho

关 键 词：老年股骨近端骨折 超声引导下髂筋膜神经阻滞 全身麻醉 

分 类 号：R614.2[医药卫生—麻醉学]