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[1]涂文劭,鄭艇,陳江湖,等.術(shù)前超聲引導(dǎo)髂筋膜間隙阻滯持續(xù)鎮(zhèn)痛在老年髖部骨折患者中的應(yīng)用[J].福建醫(yī)藥雜志,2021,43(03):4-6.
　TU Wenshao,ZHENG Ting,CHEN Jianghu,et al.Application of preoperative ultrasound-guided fascia iliaca compartment block for continuous analgesia in elderly patients with hip fracture[J].FUJIAN MEDICAL JOURNAL,2021,43(03):4-6.
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術(shù)前超聲引導(dǎo)髂筋膜間隙阻滯持續(xù)鎮(zhèn)痛在老年髖部骨折患者中的應(yīng)用()
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《福建醫(yī)藥雜志》[ISSN:1002-2600/CN:35-1071/R]

卷:
43
期數(shù):
2021年03期
頁碼:
4-6
欄目:
臨床研究
出版日期:
2021-06-15

文章信息/Info

Title:
Application of preoperative ultrasound-guided fascia iliaca compartment block for continuous analgesia in elderly patients with hip fracture
文章編號:
1002-2600(2021)03-0004-03
作者:
涂文劭; 鄭艇; 陳江湖; 高飛; 鄭曉春1
福建醫(yī)科大學(xué)省立臨床醫(yī)學(xué)院麻醉科 福建省立醫(yī)院麻醉科(福州 350001)
Author(s):
TU Wenshao;  ZHENG Ting;  CHEN Jianghu;  GAO Fei;  ZHENG Xiaochun
Department of Anaesthesiology,Provincial Clinical Medical College of Fujian Medical University,Fujian Provincial Hospital,Fuzhou,Fujian 350001,China
關(guān)鍵詞:
超聲;  髂筋膜間隙;  老年;  髖關(guān)節(jié);  鎮(zhèn)痛
Keywords:
ultrasound;  fascia iliaca compartment;  elderly patients;  hip joint;  analgesia
分類號:
R614
文獻標(biāo)志碼:
B
摘要:
目的 探討術(shù)前超聲引導(dǎo)髂筋膜間隙阻滯持續(xù)鎮(zhèn)痛在老年髖部骨折患者中應(yīng)用的可行性和有效性。 方法 選擇我院收治的老年髖部骨折患者60例,隨機分為觀察組和對照組,各30例。觀察組入院后排除神經(jīng)阻滯相關(guān)禁忌證,即刻在超聲引導(dǎo)下行髂筋膜間隙阻滯持續(xù)鎮(zhèn)痛直至術(shù)前; 對照組根據(jù)患者鎮(zhèn)痛需要間斷給予緩慢靜脈注射氟比洛芬酯注射液直至術(shù)前。比較兩組入院時、入院后第1天、第2天、術(shù)前1天平均動脈壓(MAP)、心率(HR),術(shù)前1天行雙下肢靜脈彩超檢查觀察雙下肢血栓發(fā)生情況,同時抽取外周靜脈血測定去甲腎上腺素、腎上腺素含量,并進行患者滿意度評分等。結(jié)果 與對照組比較,觀察組入院后第1天、第2天、術(shù)前1天MAP、HR均明顯降低(P<0.05); 術(shù)前1天靜脈血中去甲腎上腺素、腎上腺素含量對比,對照組高于觀察組(P<0.05); 術(shù)前行雙下肢靜脈彩超檢查發(fā)現(xiàn),對照組下肢靜脈血栓發(fā)生率高于觀察組(P<0.05); 患者滿意度評分對比,對照組低于觀察組(P<0.05)。結(jié)論 術(shù)前超聲引導(dǎo)髂筋膜間隙阻滯持續(xù)鎮(zhèn)痛應(yīng)用于老年髖部骨折患者,具有鎮(zhèn)痛效果好、創(chuàng)傷應(yīng)激小、下肢靜脈血栓發(fā)生率低、患者滿意度高等優(yōu)點,該方法值得在臨床上推廣應(yīng)用。
Abstract:
Objective To investigate the feasibility and the efficiency of preoperative ultrasound-guided fascia iliaca compartment block for continuous analgesia in elderly patients with hip fracture.Methods A total of 60 elderly patients with hip fracture were selected as the research subjects in our hospital, and then were randomly divided into observation group(n=30)and control group(n=30).For the observation group: the contraindications related to nerve block were excluded after admission, and then underwent ultrasound-guided fascia iliaca compartment block for continuous analgesia immediately. For the control group: flurbiprofen was injected at intervals according to the needs of patients analgesia.The MAP and HR at admission, on the first day, the second day after admission and the day before surgery were compared between the two groups. The thrombosis of lower extremities was examined by color doppler ultrasonography. The norepinephrine, epinephrine contents in peripheral venous blood and satisfaction score of patients were measured on the day before surgery.Results Compared with the control group, the MAP and HR were significantly decreased in the observation group on the first day, the second day after admission and the day before surgery(both P<0.05). On the day before surgery, compared with the observation group, the contents of norepinephrine and epinephrine in the venous blood were significantly higher in the control group(both P<0.05). The incidence of venous thrombosis in the control group was significantly higher in the control group than that in the observation group(P<0.05). The satisfaction score of patients was significantly lower in the control group than that in the observation group(P<0.05).Conclusion The application of preoperative ultrasound-guided fascia iliaca compartment block for continuous analgesia can significantly relieve the pain, reduce the stress response caused by trauma, reduce the incidence of venous thrombosis in lower extremity and improve satisfaction in elderly patients with hip fracture.This method is worthy of clinical application.

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備注/Memo

備注/Memo:
基金項目:福建省醫(yī)學(xué)創(chuàng)新課題(2018-CX-2)
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更新日期/Last Update: 2021-06-15