摘要
目的探究分析基于超声引导下的股神经与坐骨神经阻滞在老年下肢骨折患者中的应用效果。方法选取2021年1月—2022年1月新沂市人民医院进行手术治疗的老年下肢骨折患者212例为研究对象。按计算机随机分组法分为干预组与研究组,各106例。干预组采用腰硬联合麻醉,研究组采用超声引导下的股神经与坐骨神经阻滞麻醉。比较两组手术患者麻醉前后平均动脉压、心率,神经阻滞起效时间与持续时间,麻醉不良反应发生情况,术前与术后1h时的凝血功能变化。结果在麻醉前与麻醉后10 min,两组患者的平均动脉压、心率水平对比,差异无统计学意义(P>0.05)。两组患者的感觉神经阻滞起效时间、感觉神经阻滞持续时间、运动神经阻滞起效时间、运动神经阻滞持续时间对比,差异无统计学意义(P>0.05)。术中研究组患者低血压、心动过缓、头痛、恶心呕吐等不良反应发生率为6.60%,低于干预组的16.04%,差异有统计学意义(χ^(2)=4.700,P<0.05)。术后1 h观察组各项凝血功能指标均长于干预组,差异有统计学意义(P<0.05)。结论同腰硬联合麻醉相比,在老年下肢骨折患者中应用基于超声引导下的股神经与坐骨神经阻滞同样可以保证麻醉效果和患者的基本生命体征,并且能降低术中麻醉不良反应发生风险,延长凝血时间。
Objective To explore and analyze the application effect of ultrasound-guided femoral nerve and sciatic nerve block in elderly patients with lower extremity fractures.Methods A total of 212 elderly patients with lower extremity fracture who underwent surgical treatment in Xinyi People′s Hospital from January 2021 to January 2022 were selected as the study objects,and were divided into the intervention group and the study group by computer randomized method,with 106 cases in each group.The intervention group was given lumbo-epidural anesthesia,and the study group was given femoral nerve and sciatic nerve block anesthesia under the guidance of ultrasound.The mean arterial pressure,heart rate,the onset and duration of nerve block,the occurrence of adverse reactions to anesthesia,and the changes of coagulation function 1 h before and after anesthesia were compared between the two groups.Results Before anesthesia and 10 min after anesthesia,the mean arterial pressure and heart rate of the two groups were compared,the difference was not statistically significant(P>0.05).The onset time of sensory nerve block,duration of sensory nerve block,duration of motor nerve block and duration of motor nerve block were compared between the two groups,the difference was not statistically significant(P>0.05).The incidence of hypotension,bradycardia,headache,nausea and vomiting in the study group was 6.60%,which was lower than that in the intervention group(16.04%),the difference was statistically significant(χ^(2 )=4.700,P<0.05).The indexes of coagulation function in the observation group were longer than those in the intervention group 1 h after operation,and the difference was statistically significant(P<0.05).Conclusion Compared with combined spinal-epidural anesthesia,the application of ultrasound-guided femoral and sciatic nerve blocks in elderly patients with lower extremity fractures can also ensure the anesthesia effect and the basic vital signs of patients,and it can reduce the risk of adverse reactions of anesthesia durin
作者
张维娜
陈美杉
翟小猛
ZHANG Weina;CHEN Meishan;ZHAI Xiaomeng(Department of Anesthesiology,Xinyi People′s Hospital,Xinyi,Jiangsu Province,221400 China)
出处
《系统医学》
2023年第6期52-55,共4页
Systems Medicine
关键词
下肢骨折
超声引导
股神经与坐骨神经阻滞
腰硬联合麻醉
凝血功能
不良反应
Lower extremity fractures
Ultrasound guidance
Femoral nerve and sciatic nerve block
Spinal epidural anesthesia
Coagulation function
Adverse reactions
