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    张爱萍, 瞿玉兴. 超声引导下行腰丛复合坐骨神经阻滞麻醉在老年股骨粗隆间骨折手术中的应用效果[J]. 蚌埠医科大学学报, 2020, 45(5): 592-595. DOI: 10.13898/j.cnki.issn.1000-2200.2020.05.009
    引用本文: 张爱萍, 瞿玉兴. 超声引导下行腰丛复合坐骨神经阻滞麻醉在老年股骨粗隆间骨折手术中的应用效果[J]. 蚌埠医科大学学报, 2020, 45(5): 592-595. DOI: 10.13898/j.cnki.issn.1000-2200.2020.05.009
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    ZHANG Ai-ping, QU Yu-xing. Application value of lumbar plexus combined with sciatic nerve block anesthesia guided by ultrasound in the operation of intertrochanteric fracture of the elderly patients[J]. Journal of Bengbu Medical University, 2020, 45(5): 592-595. DOI: 10.13898/j.cnki.issn.1000-2200.2020.05.009
    Citation: ZHANG Ai-ping, QU Yu-xing. Application value of lumbar plexus combined with sciatic nerve block anesthesia guided by ultrasound in the operation of intertrochanteric fracture of the elderly patients[J]. Journal of Bengbu Medical University, 2020, 45(5): 592-595. DOI: 10.13898/j.cnki.issn.1000-2200.2020.05.009
    shu

    超声引导下行腰丛复合坐骨神经阻滞麻醉在老年股骨粗隆间骨折手术中的应用效果

    Application value of lumbar plexus combined with sciatic nerve block anesthesia guided by ultrasound in the operation of intertrochanteric fracture of the elderly patients

      摘要
    • 摘要:
      目的探讨超声引导下行腰丛复合坐骨神经阻滞麻醉应用于老年股骨粗隆间骨折手术的效果。
      方法选择老年股骨粗隆间骨折110例，按照随机数字表法分为观察组和对照组，各55例。对照组行蛛网膜下腔阻滞麻醉复合硬膜外麻醉，观察组行超声引导下腰丛复合坐骨神经阻滞麻醉。比较2组神经阻滞起效时间、维持时间和手术前后免疫球蛋白水平、疼痛程度及麻醉不良反应发生率。
      结果观察组病人感觉神经和运动神经的阻滞起效时间均明显短于对照组(P＜0.01)，维持时间均明显长于对照组(P＜0.01)。术前，2组病人IgG、IgM、IgE水平差异均无统计学意义(P＞0.05)；术后6、24、72 h，观察组IgG、IgM、IgE水平均明显高于对照组(P＜0.01)。术后6、12、24 h，观察组病人VAS评分均明显低于对照组(P＜0.01)；术后72 h，2组病人VAS评分差异无统计学意义(P＞0.05)。观察组麻醉不良反应总发生率为14.55%(8/55)，低于对照组的34.55%(19/55)(P＜0.05)。
      结论超声引导下行腰丛复合坐骨神经阻滞麻醉应用于老年股骨粗隆间骨折手术可缩短麻醉起效时间，减少对病人机体免疫功能负面影响，减轻术后疼痛，降低不良反应发生率，值得临床应用推广。

       

      Abstract:
      ObjectiveTo investigate the application value of lumbar plexus combined with sciatic nerve block anesthesia guided by ultrasound in the operation of intertrochanteric fracture of the elderly patients.
      MethodsA total of 110 elderly patients with intertrochanteric fractures were randomly divided into the observation group and control group according to the random number table(55 cases in each group).The control group was treated with subarachnoid block anesthesia combined with epidural anesthesia, and the observation group was treated with lumbar plexus combined with sciatic nerve block anesthesia guided by ultrasound.The onset and maintenance time of nerve block, immunoglobulin levels before and after operation, pain degree and incidence rate of anaesthesia adverse reactions were compared between two groups.
      ResultsThe onset time of sensory and motor nerves in observation group was shorter than that in control group(P＜0.01), and the maintenance time in observation group was longer than that in control group(P＜0.01).Before operation, the differences of the levels of IgG, IgM and IgE were not statistically significant(P＞0.05), and the levels of IgG, IgM and IgE in observation group at 6 h, 24 h and 72 h after operation were significantly higher than those in control group(P＜0.01).After 6, 12 and 24 hours of operation, the VAS scores in observation group were significantly lower than those in control group(P＜0.01), and the difference of the VAS score after 72 h of operation was not statistically significant(P＞0.05).The incidence rate of adverse reaction in observation group(14.55%) was lower than that in control group(34.55%)(P＜0.05).
      ConclusionsThe application of lumbar plexus combined with sciatic nerve block anesthesia guided by ultrasound in the operation of intertrochanteric fracture of the elderly patients can shorten the onset time of anesthesia, enhance the immune function, reduce postoperative pain and incidence rate of adverse reactions, which is worthy of promotion.

       

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