| 摘要: |
| ［摘要］ 目的 观察超声引导“领结征”髂筋膜阻滞技术在髋关节术后镇痛中的应用效果。方法 招募2020年1月至2023年5月于铜陵市人民医院择期行全髋关节置换术或人工股骨头置换术治疗的髋骨骨折患者60例，采用随机数字表法将其分为对照组和观察组，每组30例。对照组接受术后静脉镇痛，观察组在对照组镇痛方案基础上行超声引导“领结征”髂筋膜阻滞技术。比较两组术后阿片类药物用量、离床时间、住院时间、出院时Harris评分。比较两组术后2 h（T0）、6 h（T1）、12 h（T2）、24 h（T3）和48 h（T4）被动视觉模拟量表(PVAS)评分和主动视觉模拟量表(IVAS)评分。比较两组睡眠满意度、镇痛满意度及术后并发症发生率。结果 与对照组相比，观察组术后48 h内追加阿片类药物剂量更少，离床时间更早，住院时间更短，出院时Harris评分更高，差异有统计学意义（P<0.05）。两组术后PVAS评分、IVAS评分呈下降趋势，且观察组下降幅度更大（P<0.05）。在T1～T4时间点，观察组的PVAS评分、IVAS评分显著低于对照组（P<0.05）。观察组术后24 h、48 h的睡眠质量满意率高于对照组，术后镇痛总体满意率高于对照组，差异有统计学意义（P<0.05）。两组术后并发症总发生率比较差异无统计学意义（P>0.05）。结论 超声引导“领结征”髂筋膜阻滞技术可在髋关节术后中取得较好的镇痛效果，减少阿片类药物使用量，提高患者术后睡眠质量，有利于患者术后康复。 |
| 关键词: 超声引导 髂筋膜阻滞技术 髋关节 镇痛 |
| DOI：10.3969/j.issn.1674-3806.2024.07.13 |
| 分类号:R 614.4+2 |
| 基金项目:安徽省科技厅重点研发项目（编号：202104j07020003） |
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| Observation on the application effect of ultrasound-guided “bow tie sign” fascia iliaca block technique on analgesia after hip joint surgery |
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WU Gang1, WANG Hui1, CHEN Gang2, WANG Ping1, ZHAO Shihao1, WANG Fangqing2
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1.Department of Anesthesiology, Tongling People′s Hospital, Anhui 244000, China; 2.Department of Chest Surgery, Tongling People′s Hospital, Anhui 244000, China
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| Abstract: |
| ［Abstract］ Objective To observe the application effect of ultrasound-guided “bow tie sign” fascia iliaca block technique on analgesia after hip joint surgery. Methods A total of 60 patients with hip fractures who underwent elective total hip replacement or artificial femoral head replacement in Tongling People′s Hospital from January 2020 to May 2023 were recruited and divided into control group and observation group by random number table method, with 30 cases in each group. The control group received postoperative intravenous analgesia, and the observation group underwent ultrasound-guided “bow tie sign” fascia iliaca block technique for analgesia based on the analgesia regimen of the control group. Postoperative opioid consumption, time of ambulation, length of hospital stay and Harris scores at discharge were compared between the two groups. The scores of passive Visual Analogue Scale(PVAS) and initiative Visual Analogue Scale(IVAS) were compared between the two groups at the time points of 2 hours(T0), 6 hours(T1), 12 hours(T2), 24 hours(T3) and 48 hours(T4) after surgery. The sleep satisfaction, analgesia satisfaction and postoperative complication rate were compared between the two groups. Results Compared with the control group, the observation group had less opioid dosage added within 48 hours after surgery, earlier time of ambulation, shorter length of hospital stay, and higher Harris scores at discharge, and the differences were statistically significant(P<0.05). The postoperative PVAS scores and IVAS scores showed a downward trend in both groups, and the magnitudes of decreases in the postoperative PVAS scores and IVAS scores were greater in the observation group(P<0.05). From the time point of T1 to the time point of T4, the PVAS scores and IVAS scores of the observation group were significantly lower than those of the control group(P<0.05). The sleep quality satisfaction rates 24 hours and 48 hours after surgery in the observation group were higher than those in the control group, and the overall satisfaction rate of postoperative analgesia in the observation group was higher than that in the control group, and the differences were statistically significant(P<0.05). There was no significant difference in the total incidence rate of postoperative complications between the two groups(P>0.05). Conclusion Ultrasound-guided “bow tie sign” fascia iliaca block technique can achieve better analgesic effect after hip joint surgery, reduce opioid consumption, improve postoperative sleep quality of the patients, and facilitate postoperative rehabilitation of the patients. |
| Key words: Ultrasound guidance Fascia iliaca block technique Hip joint Analgesia |
