摘要
目的分析腰硬联合麻醉复合高位髂筋膜阻滞麻醉在老年股骨骨折患者中的应用效果。方法将60例老年股骨骨折患者按照随机数字表法分为观察组(30例,腰硬联合麻醉复合高位髂筋膜阻滞麻醉)和对照组(30例,腰硬联合麻醉)。比较两组的麻醉效果。结果术后6、12 h,观察组的疼痛数字等级评定量表(NRS)评分低于对照组(P<0.05)。术后24 h,观察组的简易智力状态检查量表(MMSE)评分高于对照组(P<0.05)。手术开始30 min,观察组的血浆肾素活性(PRA)、醛固酮(ALD)、去甲肾上腺素(NE)、S100β水平低于对照组,脑源性神经营养因子(BDNF)水平高于对照组(P<0.05)。术后2 h,观察组的白细胞分化抗原4阳性(CD4^(+))、白细胞分化抗原4阳性/白细胞分化抗原8阳性(CD4^(+)/CD8^(+))高于对照组,白细胞分化抗原4阳性白细胞分化抗原25阳性(CD4^(+)CD25^(+))低于对照组(P<0.05)。结论腰硬联合麻醉复合高位髂筋膜阻滞麻醉有助于改善老年股骨骨折患者的认知功能,减轻术后疼痛程度,降低手术应激反应。
Objective To analyze the application effect of combined spinal epidural anesthesia combined with high iliac fascia block anesthesia in elderly patients with femoral fracture.Methods According to the random number table method,60 elderly patients with femoral fracture were divided into observation group(30 cases,combined spinal epidural anesthesia combined with high iliac fascia block anesthesia)and control group(30 cases,combined spinal epidural anesthesia).The anesthetic effects of the two groups were compared.Results At 6 and 12 h after operation,the Numerical Rating Scale(NRS)score in the observation group was lower than that in the control group(P<0.05).At 24 h after operation,the Mini-Mental State Examination(MMSE)score of the observation group was higher than that of the control group(P<0.05).At 30 min after the beginning of the operation,the levels of plasma renin activity(PRA),aldosterone(ALD),norepinephrine(NE)and S100βin the observation group were lower than those in the control group,the level of brain-derived neurotrophic factor(BDNF)was higher than that in the control group(P<0.05).At 2 h after operation,the cluster of differentiation 4 positive(CD4^(+))and cluster of differentiation 4 positive/cluster of differentiation 8 positive(CD4^(+)/CD8^(+))in the observation group were higher than those in the control group,and the cluster of differentiation 4 positive cluster of differentiation 25 positive(CD4^(+)CD25^(+))was lower than that in the control group(P<0.05).Conclusion Combined spinal epidural anesthesia combined with high iliac fascia block anesthesia is helpful to improve the cognitive function in elderly patients with femoral fracture,reduce the degree of postoperative pain,and reduce the surgical stress response.
作者
杨洁
YANG Jie(Anesthesiology Department,Ganyu District People's Hospital of Lianyungang City,Lianyungang 222100,China)
出处
《临床医学研究与实践》
2023年第32期85-88,共4页
Clinical Research and Practice
关键词
腰硬联合麻醉
高位髂筋膜阻滞麻醉
股骨骨折
老年
combined spinal epidural anesthesia
high iliac fascia block anesthesia
femoral fracture
elderly
