| 摘要: |
| ［摘要］ 目的 探讨超声引导下腰丛复合坐骨神经阻滞对老年髋部骨折患者血流动力学和应激的影响。方法 对2016-06～2017-12该院骨科收治的63例老年髋部骨折患者进行前瞻性研究，采用随机数字表法将其分为对照组（32例）和观察组（31例）。对照组患者采用常规腰硬联合麻醉，观察组患者采用超声引导下腰丛复合坐骨神经阻滞麻醉。比较两组患者麻醉前后血流动力学相关指标平均动脉压（MAP）、收缩压（SBP）、脉搏氧饱和度（SpO2）、心率（HR），应激反应相关指标血糖（GLU）、白介素-6（IL-6）、皮质醇（COR）水平及术后简易精神状况检查量表（MMSE）和视觉模拟评分（VAS）。结果 麻醉前两组患者的血流动力学指标、应激反应相关指标差异无统计学意义（P>0.05）。麻醉后，两组患者的MAP、SBP水平和应激反应相关指标差异有统计学意义（P<0.05）；两组患者SpO2、HR差异无统计学意义（P>0.05）；观察组患者术后12 h、24 h MMSE评分均高于对照组，而VAS评分均显著低于对照组，差异有统计学意义（P<0.05）。结论 超声引导下腰丛复合坐骨神经阻滞具有一定优势，值得临床推广。 |
| 关键词: 超声引导 腰丛复合坐骨神经阻滞 髋部骨折 血流动力学 应激 |
| DOI：10.3969/j.issn.1674-3806.2019.01.14 |
| 分类号:R 614 |
| 基金项目: |
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| Effects of ultrasound-guided lumbar-sciatic nerve block on hemodynamics and stress in elderly patients with hip fractures |
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ZHOU Qin, XIE Min, HUANG Jian-xin
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Department of Anesthesiology, Sichuan Academy of Medical Sciences & Sichuan Provincial People′s Hospital, Chengdu 610072, China
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| Abstract: |
| ［Abstract］ Objective To investigate the effects of ultrasound-guided lumbar-sciatic nerve block on hemodynamics and stress in elderly patients with hip fractures. Methods A prospective study was performed on 63 elderly patients with hip fractures in the Department of Orthopedics of Sichuan Provincial People′s Hospital from June 2016 to December 2017 and the patients were divided into control group(n=32) and treatment group(n=31) using a random number table. The control group underwent conventional combined spinal and epidural anesthesia. The observation group underwent ultrasound-guided anesthesia with lumbar plexus combined with sciatic nerve block. The hemodynamic related indicators［mean arterial pressure(MAP), systolic blood pressure(SBP), pulse oximetry(SpO2) and heart rate(HR) and stress response related indicators［blood sugar(GLU), interleukin-6(IL-6) and cortisol(COR) levels］ and Postoperative Simple Mental Condition Checklist(MMSE) and Visual Analogue Scale(VAS) were compared between the two groups before and after anesthesia. Results There were no significant differences in hemodynamic parameters and stress response related indicators between the two groups before anesthesia(P>0.05). After anesthesia, the MAP and SBP levels and stress response related indicators were significantly different between the two groups(P<0.05). There were no significant differences in SpO2 and HR between the two groups(P>0.05). The MMSE scores were significantly higher and the VAS scores were significantly lower in the treatment group than those in the control group 12 and 24 hours after operation（P<0.05）. Conclusion Ultrasound-guided lumbar-sciatic nerve block has certain advantages and is worthy of clinical application. |
| Key words: Ultrasound guidance Lumbar-sciatic nerve block Hip fractures Hemodynamics Stress |
