| 闫 宏.超声引导下神经阻滞麻醉在髋关节置换术中的应用效果分析[J].中国烧伤创疡杂志,2021,(2):144~147. |
| DOI： |
| 中文关键词: 神经阻滞 髋关节置换术 麻醉 血流动力学 疼痛 认知功能 |
| 英文关键词:Nerve block Hip replacement Anesthesia Hemodynamics Pain Cognitive function |
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| 中文摘要: |
| 目的探究超声引导下神经阻滞麻醉在髋关节置换术中的应用效果。方法选取2016年4月至2019年8月开封市中心医院收治的175例行髋关节置换术治疗的患者作为研究对象，并按照麻醉方式将其分为研究组88例与对照组87例，研究组患者行超声引导下腰丛及骶丛神经阻滞麻醉，对照组患者行硬膜外麻醉，对比观察两组患者麻醉效果、平均动脉压及心率变化情况、术后疼痛及认知功能恢复情况。结果研究组患者麻醉效果优良率为100％，明显优于对照组患者的麻醉效果优良率89.66％（Z=-5.817，P＜0.001）；切皮时、手术结束时及术后30min，研究组患者平均动脉压均明显高于对照组（t=3.035、2.929、2.530，P=0.003、0.004、0.012），心率均明显低于对照组（t=2.390、3.387、2.749，P=0.018、0.001、0.007）；术后2、6、12h，研究组患者疼痛视觉模拟评分法（VAS）评分均明显低于对照组（t=2.957、3.606、3.336，P=0.004、0.001、0.001）；术后3d，研究组患者简易智能精神状态量表（MMSE）评分明显高于对照组（t=2.674，P=0.008）。结论髋关节置换术患者行超声引导下神经阻滞麻醉，可降低麻醉对血流动力学及认知功能的损害程度，且对围手术期的疼痛控制也较为理想。 |
| 英文摘要: |
| 【Abstract】 Objective To explore the application effect of ultrasound?guided nerve block in hip replacement. Methods One hundred and seventy?five patients who received hip replacement surgery in Kaifeng Central Hospital from April 2016 to August 2019 were selected as subjects to be divided into a study group （88 patients） and a control group （87 patients） based on the different anesthetic methods they received. The patients in the study group were given ultra? sound?guided nerve block through the lumbar plexus and sacral plexus，while patients in the control group received the epi? dural anesthesia. The anesthetic effect，average arterial pressure，heart rate change，postoperative pain and cognitive func? tion recovery were observed and compared between the two groups. Results The excellent and good rate of anesthetic effect in the study group was 100％ ，which was significantly better than 89. 66％ in the control group （ Z = -5.817，P ＜ 0.001）. During the skin incision，immediately after the operation and at 30 min post?operation，the average arterial pres? sures of patients in the study group were all obviously higher than that in the control group （t = 3.035，2?? .929 and 2.530，P= 0.003，0.004 and 0.012），and the heart rates in the study group were obviously lower than that in the control group （t = 2.390，3.387 and 2.749，P = 0.018，0.001 and 0.007）. At 2 h，6 h and 12 h post?operation，the visual analogue scale （VAS） scores in the study group were all markedly lower than that in the control group （t = 2.957，3.606 and 3.336，P = 0.004，0.001 and 0. 001）. On day 3 post?operation，the score of the mini?mental state examination （MMSE） in the study group was significantly higher than that in the control group （t = 2.674，P = 0.008）. Conclusion The ultrasound? guided nerve block in the treatment of hip replacement can reduce the damage of anesthesia to hemodynamics and cognitive function of patients，and has a good effect of pain relief during the perioperative period. |
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