腰丛-坐骨神经阻滞麻醉用于股骨上段骨折的麻醉效果及对心率血压的影响

doi:10.3969/j.issn.1006-6233.2018.08.015

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摘要 目的: 研究股骨上段骨折手术麻醉应用腰丛-坐骨神经阻滞的效果及对其心率、血压的影响。 方法: 选取2017年2月至2018年2月来我院骨科就诊且需手术治疗的股骨上段骨折患者110例,按照随机数字法将所有患者分为两组,对照组和研究组,各n=55例,对照组应用腰硬联合麻醉,研究组应用腰丛-坐骨神经联合阻滞麻醉。记录两组患者运动、感觉神经阻滞起效时间、完善时间及其维持的时间、手术前后心率、血压、疼痛视觉模拟评分(VAS),以比较二者的效果。 结果: 两组患者行麻醉后,其起效时间与完善时间无明显差异(P>0.05),研究组患者的运动阻滞持续时间显著低于对照组,而感觉神经阻滞持续时间则明显长于对照组的患者(P<0.05);麻醉前对照组、研究组患者的HR、SBP、DBP、VAS评分无明显差异(P>0.05),研究组在手术开始时HR明显低于对照组(P<0.05),SBP、DBP皆高于对照组(P<0.05);疼痛视觉模拟评估(VAS)统计的结果显示:手术前两组患者的VAS评分无明显差异,而在术后第1天、第3天对照组患者的VAS评分明显高于研究组(P<0.05)。 结论: 应用腰丛-坐骨神经联合阻滞股骨上段骨折患者手术的麻醉效果好,不仅可以满足手术麻醉要求,而且对循环、呼吸影响较小,值得在临床上进一步推广应用。

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	燕建新
	刘春明

关键词 ：股骨上段骨折, 麻醉, 腰丛, 坐骨神经阻滞

Abstract：Objective: To study the femoral fractures in the upper lumbar plexus anesthesia operation-the effect of sciatic nerve block and the effects on the heart rate, blood pressure. Methods: 110 cases of upper femoral fracture of the Department of orthopedics in our hospital in February -2018 February 2017 were selected and all patients were divided into two groups according to the random number method, the control group and the study group, each of the n=55 cases. The control group was treated with combined spinal epidural anesthesia, and the study group received lumbar plexus sciatic nerve block anesthesia. The onset time, duration and duration of motor and sensory nerve block were recorded in the two groups. The patients' heart rate blood pressure and visual analogue scale (VAS) before and after operation, were recorded for the two groups to compare their effects. Results: After anesthesia, there was no significant difference in onset time and improvement time between the two groups (P > 0.05). The duration of motor block in the study group was significantly lower than that in the control group, while the duration of sensory nerve block was significantly longer than that in the control group (P<0.05). There was no significant difference in HR, SBP and DBP scores between the control group and the study group before anesthesia (P > 0.05). The HR in the study group was significantly lower than the control group (P<0.05) at the beginning of the operation (P < 0.05). All the SBP and DBP were higher than those in the control group (P < 0.05). The results of visual analogue assessment (VAS) showed that the VAS scores in the control group were significantly higher than those in the study group (P < 0.05) in the first day and third day after the operation. Conclusion: The anesthesia effect of combined lumbar plexus and sciatic nerve block in the operation of the upper femoral fracture is good. It can not only meet the requirements of operation anesthesia, but also have less influence on the circulation and respiration and it is worthy of should be further applied in clinical practice.

Key words： In the upper femur fractures Anesthesia Lumbar plexus Sciatic nerve block The quality

基金资助:黑龙江省教育厅科学技术研究项目,(编号:12551925)

引用本文:

燕建新, 刘春明. 腰丛-坐骨神经阻滞麻醉用于股骨上段骨折的麻醉效果及对心率血压的影响[J]. 河北医学, 2018, 24(8): 1289-1292.
YAN Jianxin, LIU Chunming. Anesthetic Effect of Lumbar Plexus Sciatic Nerve Block Anesthesia on Upper Femoral Fracture and Its Effects on Heart Rate and Blood Pressure During Operation Anesthesia. HeBei Med, 2018, 24(8): 1289-1292.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2018.08.015 或 http://www.hbyxzzs.cn/CN/Y2018/V24/I8/1289

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