摘要
目的探讨老年患者股骨粗隆间骨折腰丛-坐骨神经阻滞麻醉的效果。方法选取2010年12月-2015年12月在华北石油管理局总医院治疗的股骨粗隆间骨折老年患者共86例，根据患者麻醉方式随机分为试验组（腰丛-坐骨神经阻滞麻醉，41例）和对照组（腰硬联合麻醉，45例），观察两组心率、平均动脉压、神经阻滞起效、维持时间、镇痛效果、麻醉不良反应、平均住院时间、手术并发症和Harris评分。结果试验组最大心率变化率和最大平均动脉压变化率均低于对照组（P〈0．05）。试验组感觉神经及运动神经阻滞起效时间晚，但维持时间长（P〈0．05）。试验组镇痛效果优于对照组（P〈0．05）。试验组麻醉不良反应、平均住院时间、手术并发症均显著少于对照组（P〈0．05）。术后3个月试验组Harris评分高于对照组（P〈0．05）。结论腰丛-坐骨神经联合阻滞具有起效迅速，血流动力学稳定，术后并发症少等优势，更适用于老年患者股骨粗隆间骨折手术麻醉。
Objective To explore the clinical efficacy of lumbar plexus combined sciatic nerve block in elderly patients undergoing intertrochanteric fracture. Methods The elderly patients with intertrochanterie fracture were diagnosed and treated in the General Hospital of North China Petroleum Bureau from December, 2010 to December, 2015. According to the different anesthesia methods, 86 patients were divided into the test group （n=41, Lumbar plexus combined sciatic nerve block） and the control group （n=45, lumbar-epidural combined with anesthesia）.Resuhs of vital signs （MAP and heart rate）, clinical efficacy, average length of stay, Harris hip scores and complication rate in the two groups were compared. Results The rate of MAP and HR change in test group were significantly lower than those in the control group （P〈0.05）. The duration of sensory and motion blockade in the test group was obviously longer than the control group, and it works latter in the test group than the control group （P〈0.05）. There were significantly difference between the two groups of analgesic effect （P〈0.05）. The average length of stay, anaesthesia and surgery complication rate of the test group were significantly lower than those in the control group （P〈0.05）. There were significantly difference between the two groups of the Harris hip scores （P〈0.05）. Conclusion Lumbar plexus combined sciatic nerve block used in elderly patients undergoing intertrochanteric fracture achieved good clinical effect, effectively maintained hemodynamic stability and reduced the complication rate. It is worthy of clinical promotion for elderly patients undergoing intertrochanteric fracture.
出处
《中国急救复苏与灾害医学杂志》
2017年第7期646-648,共3页
China Journal of Emergency Resuscitation and Disaster Medicine
关键词
腰丛-坐骨神经阻滞
老年人
股骨粗隆间骨折
疗效
Lumbar plexus combined sciatic nerve block
Elderly
intertrochanteric fracture
clinical efficacy
