| 李志冰.超声引导下改良髂筋膜间隙阻滞在老年股骨近端骨折患者手术中的应用效果[J].中国医药科学,2023,(20):90-94 基金项目: |
| 超声引导下改良髂筋膜间隙阻滞在老年股骨近端骨折患者手术中的应用效果 |
| Application effect of modified-fascia iliac compartment block under ultrasound guidance in the operation for elderly patients with proximal femoral fracture |
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| DOI： |
| 中文关键词: 老年；股骨近端骨折；手术；超声引导；改良髂筋膜间隙阻滞 |
| 英文关键词:Senile; Proximal femoral fracture; Surgery; Ultrasound guidance; Modified-fascia iliac compartment block |
| 作者 | 单位 | | 李志冰 | 山东省临沂市中心医院麻醉科，山东临沂 276400 |
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| 中文摘要: |
| [摘要] 目的 探讨超声引导下改良髂筋膜间隙阻滞（M-FICB）在老年股骨近端骨折患者手术中的应用效果。 方法 将2020年6月至2021年12月在临沂市中心医院麻醉科治疗的60例老年股骨近端骨折手术患者按随机数表法分为两组，每组各30例。对照组单用全身麻醉，观察组在此基础上，使用超声引导下M-FICB。比较两组的血流动力学、术后疼痛、手术及术后恢复指标和不良反应发生情况。 结果 观察组切皮时、扩髓腔时、术毕时的平均动脉压（MAP）、心率（HR）明显高于对照组，差异有统计学意义（P < 0.05），而两组入室时MAP、HR比较，差异无统计学意义（P > 0.05）。观察组术后6、12、24 h的视觉模拟评分法（VAS）评分均明显低于对照组，术后第一次补救镇痛时间明显长于对照组，术后24 h补救镇痛次数少于对照组，差异有统计学意义（P < 0.05）。两组手术时间比较，差异无统计学意义（P > 0.05），但观察组苏醒时间、人工气道拔除时间短于对照组，舒芬太尼、瑞芬太尼、丙泊酚用药量均少于对照组，差异有统计学意义（P < 0.05）。观察组不良反应总发生率明显低于对照组，差异有统计学意义（P < 0.05）。 结论 超声引导下M-FICB在老年股骨近端骨折患者手术中的应用效果显著，有助于稳定术中血流动力学，不影响手术进程，且缩短术后恢复时间，减轻术后疼痛，降低不良反应发生率。 |
| 英文摘要: |
| [Abstract] Objective To investigate the application effect of modified-fascia iliac compartment block (M-FICB) under ultrasound guidance in the operation for elderly patients with proximal femoral fracture. Methods A total of 60 elderly patients with proximal femoral fracture treated in the Department of Anesthesiology of Linyi Central Hospital from June 2020 to December 2021 were divided into the control group (n=30) and the observation group (n=30) according to the random number table method. The control group was only treated with general anesthesia, while on this basis, the observation group was treated with M-FICB under ultrasound guidance. The hemodynamics, postoperative pain, surgical and postoperative recovery indices and the incidence of adverse reactions (ARs) were compared between the two groups. Results The mean arterial pressure (MAP) and heart rate (HR) in the observation group were significantly higher than those in the control group at the time of skin incision, pulp cavity expansion, and at the end of the surgery, with statistically significant differences (P < 0.05). However, the MAP and HR in the two groups were similar at the time of entering the room, without statistically significant differences (P > 0.05). After operation, the VAS pain scores of the observation group at 6, 12 and 24 h were all significantly lower than those of the control group. After operation, the first time of remedial analgesia was significantly longer than that of the control group, and the number of remedial analgesia at 24 h after operation was less than that of the control group, with statistically significant differences (P < 0.05). The operation time of the two groups was similar, without statistically significant difference (P > 0.05). However, the recovery time and artificial airway removal time of the observation group were shorter than those of the control group, and the dosages of sufentanil, remifentanil and propofol were all lower than those of the control group, with statistically significant differences (P < 0.05). The total incidence of ARs in the observation group was significantly lower than that in the control group, with statistically significant difference (P < 0.05). Conclusion The application of M-FICB under ultrasound guidance has a significant efficacy in the operation of elderly patients with proximal femoral fracture, which helps to stabilize intraoperative hemodynamics, does not impact the operation process, and shortens the postoperative recovery time, relieves postoperative pain and reduces the incidence of ARs. |
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