超声引导下髋关节囊周围神经阻滞联合腰硬联合麻醉在老年股骨颈骨折全髋关节置换术患者中的应用效果  

Application effects of ultrasound-guided pericapsular nerve group block anesthesia and combined spinal-epidural anesthesia in elderly patients with femoral neck fractures undergoing total hip arthroplasty

作　　者：温定福 刘娟 刘福来 WEN Dingfu;LIU Juan;LIU Fulai(Department of Anesthesiology of Xingguo County Hospital of Traditional Chinese Medicine,Ganzhou 342400 Jiangxi,China;Jiangbei Health Center of Xingguo County,Ganzhou 342400 Jiangxi,China)

机构地区：[1]兴国县中医院麻醉科,江西赣州342400 [2]兴国县江背卫生院,江西赣州342400

出　　处：《中国民康医学》2025年第9期63-65,69,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:观察超声引导下髋关节囊周围神经阻滞(PENG)联合腰硬联合麻醉在老年股骨颈骨折全髋关节置换术患者中的应用效果。方法:选取2022年8月至2024年7月兴国县中医院收治的62例老年股骨颈骨折全髋关节置换术患者进行前瞻性研究,根据随机数字表法将其分为对照组与研究组各31例。对照组采用腰硬联合麻醉,研究组在对照组基础联合超声引导下PENG,比较两组麻醉相关指标(感觉阻滞持续时间、麻醉起效时间、运动神经阻滞持续时间)水平、不同时间血流动力学指标(心率、平均动脉压、血氧饱和度)水平和麻醉不良反应发生率。结果:研究组感觉阻滞持续时间、麻醉起效时间、运动神经阻滞持续时间均短于对照组,差异有统计学意义(P<0.05);切皮时、手术结束时,对照组心率、平均动脉压水平均低于麻醉前,且研究组切皮时、手术结束时心率、平均动脉压水平均高于对照组,差异有统计学意义(P<0.05);研究组麻醉前、切皮时、手术结束时心率、平均动脉压水平比较,差异均无统计学意义(P>0.05);两组麻醉前、切皮时、手术结束时血氧饱和度水平比较,差异均无统计学意义(P>0.05);两组麻醉不良反应发生率比较,差异无统计学意义(P>0.05)。结论:超声引导下PENG联合腰硬联合麻醉应用于老年股骨颈骨折全髋关节置换术患者可改善麻醉相关指标和血流动力学指标水平的效果优于单纯腰硬联合麻醉。Objective:To observe application effects of ultrasound-guided pericapsular nerve group block(PENG)anesthesia and combined spinal-epidural anesthesia in elderly patients with femoral neck fracture undergoing total hip arthroplasty.Methods:A prospective study was conducted on 62 elderly patients with femoral neck fractures undergoing total hip arthroplasty admitted to Xingguo County Hospital of Traditional Chinese Medicine from August 2022 to July 2024.According to the random number table method,they were divided into control group and study group,31 cases in each group.The control group was treated with combined spinal-epidural anesthesia,while the study group was treated with ultrasound-guided PENG anesthesia on the basis of that of the control group.The levels of anesthesia-related indexes(sensory block duration,anesthesia onset time,motor nerve block duration)and hemodynamic indexes(heart rate,mean arterial pressure,blood oxygen saturation)at different time,and the incidence of anesthesia adverse reactions were compared between the two groups.Results:The the sensory block duration,the anesthesia onset time and the motor nerve block duration in the study group were shorter than those in the control group,and the differences were statistically significant(P<0.05).At the time of skin incision and the end of operation,the heart rate and mean arterial pressure of the control group were lower than those before anesthesia,and those of the study group were higher than those in the control group,and the differences were statistically significant(P<0.05).There were no significant differences in the levels of heart rate and mean arterial pressure before anesthesia,at skin incision and at the end of operation in the study group(P>0.05).There was no significant difference in the blood oxygen saturation between the two groups before anesthesia,at skin incision and at the end of operation(P>0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Ultrasound-gui

关 键 词：老年 股骨颈骨折 全髋关节置换术 超声引导下髋关节囊周围神经阻滞 腰硬联合麻醉 

分 类 号：R614.4[医药卫生—麻醉学]