| 龚 钦.髂筋膜阻滞联合右美托咪定在伴高血压的股骨近端骨折患者手术中的应用效果分析[J].中国烧伤创疡杂志,2022,(2):120~124. |
| DOI： |
| 中文关键词: 髂筋膜阻滞 右美托咪定 全身麻醉 股骨近端骨折 高血压 |
| 英文关键词:Fascia iliaca block Dexmedetomidine General anesthesia Proximal femoral fracture Hypertension |
| 基金项目: |
|
| 摘要点击次数: 1560 |
| 全文下载次数: 4605 |
| 中文摘要: |
| 【摘要】 目的 探讨髂筋膜阻滞联合右美托咪定在伴高血压的股骨近端骨折患者手术中的应用效果。方法 选取2019年3月至2019年12月郑州市骨科医院收治的80例拟行股骨近端骨折手术治疗的伴有高血压的患者作为研究对象，按照随机数表法将其随机分为观察组(40例)与对照组(40例)，观察组患者于全身麻醉诱导前20 min行超声引导下髂筋膜阻滞联合右美托咪定静脉泵注，对照组患者单纯采用全身麻醉，对比两组患者心率(HR)、平均动脉压(MAP)、经皮动脉血氧饱和度(SpO2 )变化情况以及视觉模拟评分法(VAS)评分、麻醉起效时间、阻滞消退时间、拔管时间、首次下床时间与不良反应发生情况。结果 手术开始20 min时，观察组患者HR、MAP、SpO2均明显低于对照组(t =2.313、3.521、7.618，P=0.023、P＜0.001、P＜0.001)，而手术结束时，两组患者HR、MAP、SpO2均无明显差异(t=0.377、1.145、1.021，P= 0.707、0.256、0.311)；术后2、5、10、24、48 h，观察组患者VAS评分均明显低于对照组(t=4.639、4.134、3.682、4.866、3.535，P均＜0.001)；观察组患者麻醉起效时间、阻滞消退时间、首次下床时间以及拔管时间均短于对照组(t=4.581、2.959、2.772、2.477，P＜0.001、P=0.004、P=0.007、P=0.015)；术后，观察组患者不良反应发生率为5.00%，与对照组患者的不良反应发生率10.00%无明显差异(χ2 =0.721，P=0.396)。结论 与全身麻醉相比，于全身麻醉诱导前20 min行超声引导下髂筋膜阻滞联合右美托咪定静脉泵注更有利于提高伴高血压的股骨近端骨折手术患者的麻醉效果，减轻患者痛苦，疗效更显著。 |
| 英文摘要: |
| 【Abstract】 Objective To discuss the application effect of fascia iliaca block and dexmedetomidine in the surgery of proximal femoral fracture in patients with hypertension. Methods 80 patients with proximal femoral fracture and hyper-tension, admitted into Zhengzhou Orthopaedic Hospital from March 2019 to December 2019 for surgical treatment, were enrolled as research subjects, and divided, using the random number table, into observation group (n = 40) and control group (n= 40). Patients in observation group received ultrasound-guided fascia iliaca block and intravenous pumping of dexmedetomidine 20 minutes before the induction of general anesthesia, whereas patients in control group underwent generalanesthesia only. Changes of heart rate (HR), mean arterial pressure (MAP), percutaneous arterial oxygen saturation (SpO2 ), visual analogue scale (VAS) score, anesthesia onset time, block regression time, extubation time, first off-bed time and occurrence of adverse reactions were compared between the two groups. Results At 20 minutes after operation starting, HR, MAP and SpO2 of patients in observation group were significantly lower than control group (t =2.313, 3.521 and 7.618, P=0.023, P＜0.001, P＜0.001). However, no significant differences were observed between the two groups in terms of HR, MAP and SpO2 at the end of the operations (t =0.377, 1.145 and 1.021, P =0.707, 0.256 and 0.311).At 2 h, 5 h, 10 h, 24 h and 48 h after the operations, the VAS scores of patients in observation group were all significantly lower than control group (t =4.639, 4.134, 3.682, 4.866 and 3.535, all P＜0.001). The anesthesia onset time, block regression time, first off-bed time and extubation time in observation group were shorter than control group (t=4.581,2.959, 2.772 and 2.477, P＜0.001, P =0.004, P=0.007, P=0.015). After the operations, the incidence of adverse reactions in observation group was 5.00%, showing no statistically significant difference as compared with 10.00% in control group (χ2 =0.721, P =0.396). Conclusion Compared with general anesthesia, ultrasound-guided fascia iliaca block combined with intravenous pumping of dexmedetomidine 20 minutes before the induction of general anesthesia can realize better anesthetic effect in patients with proximal femoral fracture and hypertension to alleviate their pain, and thus secure better therapeutic effect. |
|
|
|
|
