摘要
目的探讨高龄髋部骨折患者采用超声引导下肢神经阻滞麻醉的麻醉效果。方法选取2019年10月至2023年9月在镇平县人民医院接受治疗的82例高龄髋部骨折患者,以随机数字表法分为对照组(41例)与研究组(41例),对照组给予气管插管全身麻醉,研究组给予超声引导下肢神经阻滞麻醉,对两组术后恢复指标、认知功能[简易精神状态检查量表(MMSE)]、疼痛程度[视觉模拟评分法(VAS)]、血流动力学[心率(HR)、血氧饱和度(SpO2)、舒张压(DBP)、收缩压(SBP)]、并发症进行比较。结果研究组苏醒、下床活动、住院时间均短于对照组,差异均有统计学意义(P<0.05);术后24 h,研究组MMSE评分低于术前,差异具有统计学意义(P<0.05),术后72 h与术前比较差异无统计学意义(P>0.05),对照组术后24 h、术后72 h MMSE评分均低于术前,差异均有统计学意义(P<0.05),但研究组术后24 h、术后72 h均高于对照组,差异均有统计学意义(P<0.05);两组术后6 h、术后12 h时VAS评分低于术后2 h,差异均有统计学意义(P<0.05),研究组各时间点VAS评分均低于对照组,差异均有统计学意义(P<0.05);两组麻醉诱导后血流动力各项指标均低于麻醉诱导前,差异具有统计学意义(P<0.05),但研究组血流动力各项指标均高于对照组,差异具有统计学意义(P<0.05);研究组并发症发生率(7.32%)低于对照组(29.27%),差异具有统计学意义(P<0.05)。结论超声引导下肢神经阻滞麻醉应用于高龄髋部骨折患者中,能够加快术后康复,缓解疼痛程度,减轻对认知功能的影响,稳定血流动力学,减少并发症发生。
Objective To explore the anesthetic effect of ultrasound-guided lower limb nerve block anesthesia in elderly patients with hip fracture.Methods A total of 82 elderly patients with hip fractures treated in Zhenping County People’s Hospital from October 2019 to September 2023 were selected.They were divided into the control group(41 cases)and the research group(41 cases)according to the random number table method.The control group was given tracheal intubation general anesthesia,and the research group was given ultrasound-guided lower limb nerve block anesthesia.The postoperative recovery indicators,cognitive function[Mini-Mental State Examination(MMSE)],degree of pain[Visual Analogue Scale(VAS)],hemodynamics[heart rate(HR),blood oxygen saturation(SpO2),diastolic blood pressure(DBP),systolic blood pressure(SBP)],and complications of the two groups were compared.Results The recovery,getting out of bed,and hospital stay of the research group were all shorter than those of the control group,with statistically significant differences(P<0.05).At 24 hours after surgery,the MMSE score of the research group was lower than before surgery,with a statistically significant difference(P<0.05),and there was no statistically significant difference compared with before surgery at 72 hours after surgery(P>0.05).The MMSE scores of the control group at 24 hours and 72 hours after surgery were both lower than before surgery,with statistically significant differences(P<0.05),but the MMSE scores of the research group at 24 hours and 72 hours after surgery were both higher than those of the control group,with statistically significant differences(P<0.05).The VAS scores of the two groups at 6 hours and 12 hours after surgery were lower than at 2 hours after surgery,with statistically significant differences(P<0.05),and the VAS scores of the research group at each time point were all lower than those of the control group,with statistically significant differences(P<0.05).After anesthesia induction,the hemodynamic indicators of the two groups were all lower than before anesthesia induction,with statistically significant differences(P<0.05),but the hemodynamic indicators of the research group were all higher than those of the control group,with statistically significant differences(P<0.05).The incidence of complications in the research group(7.32%)was lower than that in the control group(29.27%),with a statistically significant difference(P<0.05).Conclusion Ultrasound-guided lower limb nerve block anesthesia applied in elderly patients with hip fractures can accelerate postoperative recovery,alleviate the degree of pain,reduce the impact on cognitive function,stabilize hemodynamics,and reduce the occurrence of complications.
作者
刘文双
王亚丽
王娟
LIU Wenshuang;WANG Yali;WANG Juan(Department of Anesthesiology,Zhenping County People’s Hospital,Nanyang Henan 474250,China)
出处
《临床研究》
2024年第7期92-95,共4页
Clinical Research
关键词
超声引导
下肢神经阻滞麻醉
高龄
髋部骨折
麻醉效果
ultrasound guidance
lower limb nerve block anesthesia
elderly
hip fracture
anesthetic effect
作者简介
刘文双,男,副主任医师,本科。研究方向:骨科高龄患者麻醉。
