摘要
目的:观察丙泊酚联合腰丛-坐骨神经阻滞对股骨颈骨折患者术后认知功能及应激反应的影响。方法:依据随机数字表法将2022年2月—2023年5月莆田九十五医院收治的82例股骨颈骨折患者分为两组,各41例。对照组实施连续硬膜外阻滞麻醉,观察组实施丙泊酚联合腰丛-坐骨神经阻滞。比较两组血流动力学、应激反应、认知功能及不良反应。结果:两组T_(3)、T_(4)时平均动脉压(MAP)均低于T_(1)、T_(2)时,观察组T_(3)、T_(4)时MAP均高于对照组(P<0.05);两组术后1 d血清皮质醇(Cor)、去甲肾上腺素(NE)均高于术前,但观察组均较对照组低(P<0.05);观察组术后第2、4天简易智力状态检查量表(MMSE)评分均较对照组高(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:丙泊酚联合腰丛-坐骨神经阻滞可减轻股骨颈骨折患者术中应激反应,利于稳定术中血压水平,且对患者的认知功能影响较小,具有良好的安全性。
Objective:To observe the effect of Propofol combined with lumbar plexus-sciatic nerve block on postoperative cognitive function and stress response in patients with femoral neck fracture.Method:A total of 82 patients with femoral neck fracture admitted to Putian 95th Hospital from February 2022 to May 2023 were divided into two groups according to random number table method,with 41 cases in each group.The control group received continuous epidural block anesthesia,and the observation group received Propofol combined with lumbar plexussciatic nerve block.The hemodynamics,stress response,cognitive function and adverse reactions were compared between the two groups.Result:The mean arterial pressure(MAP)of the two groups at T_(3) and T_(4) were lower than those at T_(1) and T_(2),and the MAP at T_(3) and T_(4) in observation group were higher than those in control group(P<0.05).Serum cortisol(Cor)and norepinephrine(NE)in the two groups 1 day after surgery were higher than those before surgery,but those in the observation group were lower than those in the control group(P<0.05).The scores of minimental state examination(MMSE)in the observation group were higher than those in the control group on the 2nd and 4th day after surgery(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Propofol combined with lumbar plexus-sciatic nerve block can alleviate the intraoperative stress response in patients with femoral neck fracture,stabilize the intraoperative blood pressure level,and have little impact on the cognitive function of patients,with good safety.
作者
杨宗明
胡贵
朱文涛
YANG Zongming;HU Gui;ZHU Wentao(Department of Anesthesiolog,Putian 95th Hospital,Putian 351100,China;不详)
出处
《中国医学创新》
CAS
2024年第12期112-116,共5页
Medical Innovation of China
关键词
股骨颈骨折
丙泊酚
腰丛-坐骨神经阻滞
认知功能
应激反应
Femoral neck fracture
Propofol
Lumbar plexus-sciatic nerve block
Cognitive function
Stress response
