| 张春燕,张 雁.超声引导下髂筋膜间隙阻滞在股骨颈骨折术中的应用效果分析[J].中国烧伤创疡杂志,2023,(3):219~223. |
| DOI： |
| 中文关键词: 股骨颈骨折 喉罩全身麻醉 超声引导 髂筋膜间隙阻滞 血流动力学 不良反应 |
| 英文关键词:Femoral neck fracture General anesthesia with laryngeal mask Ultrasound guidance Fascia iliaca compartment block Hemodynamics Adverse reactions |
| 基金项目: |
|
| 摘要点击次数: 1543 |
| 全文下载次数: 4206 |
| 中文摘要: |
| 【摘要】 目的 分析探讨超声引导下髂筋膜间隙阻滞 (FICB) 在股骨颈骨折患者手术中的应用效果。方法 选取2020年2月至 2021年 6月河南电力医院收治的80例拟行髋关节置换术的股骨颈骨折患者作为研究对象, 按照随机数表法将其随机分为观察组(40例)与对照组 (40例),观察组患者采用超声引导下FICB复合喉罩全身麻醉, 对照组患者单纯采用喉罩全身麻醉,对比观察两组患者麻醉诱导前、牵引复位时、术毕时、术后6 h的心率(HR)、平均动脉压（MAP）、血氧饱和度（SpO2）, 以及麻醉过程中丙泊酚与舒芬太尼用量, 术后3 d内患者自控镇痛(PCA)泵按压次数与术中及术后不良反应发生情况。结果 牵引复位时、术毕时及术后 6 h 观察组患者HR均明显低于对照组(t = 11.940、6.353、2.021, P＜0.001、P＜0.001、P=0.047), SpO2均明显高于对照组 (t=3.672、6.103、2.693, P＜0.001、P＜0.001、P =0.008); 除术后 6 h 两组患者 MAP无明显差异外,牵引复位时、术毕时观察组患者MAP均明显低于对照组 (t=8.754、8.332, P均＜0.001);观察组患者麻醉过程中丙泊酚、舒芬太尼用量及术后3 d内PCA泵按压次数均明显少于对照组(t= 9.142、7.608、8.284, P均＜0.001); 术中及术后,观察组患者不良反应发生率为 2.50%,与对照组患者的不良反应发生率7.50%无明显差异(χ2=0.263,P=0.608)。 结论 在喉罩全身麻醉的基础上行超声引导下FICB,可明显减轻股骨颈骨折患者术中血流动力学波动, 减少麻醉药物用量及术后镇痛次数。 |
| 英文摘要: |
| 【Abstract】 Objective To discuss the application effect of ultrasound?guided fascia iliaca compartment block (FICB) in the operation of femoral neck fracture. Methods 80 patients with femoral neck fracture admitted into Henan Electric Power Hospital for hip replacement between February 2020 and June 2021 were enrolled as research subjects, and then divided into study group (n = 40) and control group ( n = 40) using the random number table. Patients in the study group underwent ultrasound-guided FICB plus the general anesthesia with laryngeal mask, while patients underwent the general anesthesia with laryngeal mask alone in the control group. The following items were compared between the two groups, including heart rate (HR), mean arterial pressure (MAP) and blood oxygen saturation (SpO2 ) respectively before anesthesia induction, during the traction reduction, immediately after operation and at 6 h after operation, the dosage ofPropofol and Sufentanil during the anesthesia, number of times of patients pressing the patient controlled analgesia (PCA) pump within 3 days after operation, and the occurrence of adverse reactions after operation. Results Respectively at the time points of during the traction reduction, immediately after operation and at 6 h after operation, the levels of HR of patients were all obviously lower in the study group compared with the control group (t = 11.940, 6.353 and 2.021, P <0.001, P < 0.001, P = 0.047), and the levels of SpO2 of patients were all markedly higher in the study group (t = 3.672,6.103 and 2.693, P < 0.001, P < 0.001, P = 0.008). Except no significant difference being observed between the two groups in terms of MAP at 6 h after operation, the levels of MAP of patients at the other two time points were both significantly lower in the study group compared with the control group ( t = 8.754 and 8.332, both P < 0.001). The dosages of Propofol and Sufentanil during the anesthesia, and the number of times of patients pressing the PCA pump within 3 days after operation were all significantly less in the study group compared with the control group (t = 9.142, 7.608 and 8.284,all P < 0.001). During the operation and after operation, the incidence of adverse reactions of patients in the study group was 2.50% , showing no significantly difference compared with the corresponding 7.50% in the control group (χ2= 0.263,P = 0.608). Conclusion On the basis of general anesthesia with laryngeal mask, the application of ultrasound-guided FICB can significantly alleviate the hemodynamic fluctuation of patients during the operation for femoral neck fracture, and reduce the dosage of anesthetics and the number of times of using analgesic drugs. |
|
|
|
|
