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医学临床研究  2024, Vol. 41 Issue (4): 569-571    DOI: 10.3969/j.issn.1671-7171.2024.04.025
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超声引导下神经阻滞联合全麻用于老年下肢骨折术中的效果
张衍平1, 李现虎1, 李康2
1.山东省立第三医院麻醉科,山东 济南 250000;
2.肥城市人民医院手术麻醉科,山东 肥城 271600
The Effect of Ultrasound-guided Nerve Block Combined with General Anesthesia for Elderly Lower Limb Fracture Surgery
ZHANG Yanping, LI Xianhu, LI Kang
Department of Anesthesiology, Shandong Provincial Third Hospital, Jinan Shandong 250000
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摘要 【目的】探讨超声引导下神经阻滞联合全麻用于老年下肢骨折术中的效果。【方法】268例接受下肢骨折术的老年患者,随机分为观察组(超声引导下神经阻滞联合全麻,134例)与对照组(全麻,134例)。比较两组麻醉效果、麻醉药物使用剂量、苏醒时间、拔除喉罩时间、疼痛视觉模拟评分(VAS)及不良反应;比较两组不同时点的平均动脉压(MAP)、心率(HR)、凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)。【结果】观察组麻醉优良率高于对照组(P<0.05);观察组麻醉药物使用剂量少于对照组,苏醒时间、拔除喉罩时间短于对照组,术后VAS评分低于对照组(P<0.05);观察组插喉罩时(T1)、切皮时(T2)、拔喉罩时(T3)的MAP、HR与麻醉前(T0)比较,差异均无统计学意义(P>0.05),对照组在T1、T2、T3时的MAP、HR均显著高于T0时,观察组在T1、T2、T3时的MAP、HR显著低于对照组(P<0.05);观察组在T2、T3时的PT、TT、APTT均显著高于对照组(P<0.05);观察组不良反应总发生率低于对照组(P<0.05)。【结论】超声引导下神经阻滞联合全麻对老年下肢骨折术患者血流动力学的影响较小,麻醉效果更好,围术期患者体征稳定,临床应用价值较高。
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张衍平
李现虎
李康
关键词 骨折固定术下肢骨超声检查神经传导阻滞麻醉    
Abstract:【Objective】To explore the effect of ultrasound-guided nerve block and general anesthesia combined for elderly lower limb fracture surgery. 【Methods】A total of 268 elderly patients who underwent lower limb fracture surgery were randomly divided into an observation group (using ultrasound-guided nerve block combined with general anesthesia, 134 cases) and a control group (using general anesthesia, 134 cases). Comparisons were made between two groups in terms of anesthesia effectiveness, dosage of anesthetic drugs, awakening time, removal time of laryngeal mask, pain visual analogue scale (VAS), and adverse reactions; The average arterial pressure (MAP), heart rate (HR), prothrombin time (PT), thrombin time (TT), and activated partial thromboplastin time (APTT) levels were compared between two groups at different time points.【Result】 The excellent anesthesia rate in the observation group was higher than that in the control group (P<0.05); The observation group used less anesthesia, had shorter awakening time and removal time of the laryngeal mask, and had lower postoperative VAS scores than the control group (P<0.05); There was no statistically significant difference (P>0.05) in the MAP and HR of the observation group at the insertion (T1), incision (T2), and removal (T3) of the laryngeal mask compared to before anesthesia (T0). The MAP and HR of the control group were significantly higher at T1, T2, and T3 than at T0, while the MAP and HR of the observation group were significantly lower at T1, T2, and T3 than those of the control group (P<0.05); The PT, TT, and APTT of the observation group were significantly higher than those of the control group at time points T2 and T3 (P<0.05); The total incidence of adverse reactions in the observation group was lower than that in the control group (P<0.05).【Conclusion】 Ultrasound guided nerve block combined with general anesthesia has a relatively small impact on hemodynamics in elderly patients undergoing lower limb fracture surgery, better anesthesia effect, stable signs during surgery, and high clinical application value.
Key wordsFracture Fixation    Bones of Lower Extremity    Ultrasonography    Nerve Block    Anesthesia
收稿日期: 2023-10-20     
中图分类号:  R683.42  
引用本文:   
张衍平, 李现虎, 李康. 超声引导下神经阻滞联合全麻用于老年下肢骨折术中的效果[J]. 医学临床研究, 2024, 41(4): 569-571.
ZHANG Yanping, LI Xianhu, LI Kang. The Effect of Ultrasound-guided Nerve Block Combined with General Anesthesia for Elderly Lower Limb Fracture Surgery. JOURNAL OF CLINICAL RESEARCH, 2024, 41(4): 569-571.
链接本文:  
http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2024.04.025     或     http://journal07.magtech.org.cn/yxlcyj/CN/Y2024/V41/I4/569
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