超声引导下改良腰丛神经阻滞用于人工全髋关节置换术中的效果

doi:10.3969/j.issn.1671-7171.2026.02.007

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摘要 【目的】 探讨超声引导下改良腰丛神经阻滞(LPB)用于人工全髋关节置换术(THA)中的效果。【方法】 本院120例行THA的患者,依据术前麻醉方式的不同分为观察组和对照组,每组60例。观察组行超声引导下改良LPB联合骶丛神经阻滞,对照组行超声引导下LPB联合骶丛神经阻滞。比较两组患者临床相关指标和麻醉效果,入室时(T₀)、麻醉后5 min(T₁)、手术开始30 min(T₂)时的血流动力学指标[平均脉动圧(MAP)、心率(HR)],入室前、术后12 h血清疼痛因子[前列腺素E₂(PGE₂)、神经肽Y(NPY)、神经生长因子(NGF)]水平及不良反应发生情况。【结果】 两组患者穿刺时间、阻滞完成时间、手术时间、股神经恢复时间比较,差异均无统计学意义(P>0.05);观察组术中舒芬太尼用量明显少于对照组(P<0.05)。两组患者各时点MAP、HR比较,差异无统计学意义(P>0.05);观察组T₂时MAP、HR均低于同组T₀、T₁时(P<0.05)。观察组麻醉优良率(98.33%)明显高于对照组(88.33%)(P<0.05)。两组患者术后12 h血清PGE₂、NPY、NGF水平均高于同组入室前(P<0.05),但观察组均显著低于对照组(P<0.05)。两组患者不良反应发生情况比较,差异无统计学意义(P>0.05)。【结论】 超声引导下改良LPB用于THA中,能够获得良好的麻醉效果,且可减少阿片类药物的用量,提高术后镇痛效果。

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	刘勇斌
	马鹏
	王仁军

关键词 ：关节成形术,置换,髋, 神经传导阻滞, 超声检查

Abstract：【Objective】 To investigate the effect of ultrasound-guided modified lumbar plexus block(LPB) in patients undergoing total hip arthroplasty (THA).【Methods】 A total of 120 patients undergoing THA in our hospital were divided into an observation group and a control group according to different preoperative anesthesia methods, with 60 patients in each group. The observation group received ultrasound-guided modified LPB combined with sacral plexus block, while the control group received ultrasound-guided LPB combined with sacral plexus block. Clinical indicators and anesthetic effects were compared between the two groups. Hemodynamic parameters, including mean arterial pressure (MAP) and heart rate (HR), were recorded upon entering the operating room (T₀), 5 minutes after anesthesia (T₁), and 30 minutes after the start of surgery (T₂). Serum pain-related factors-prostaglandin E₂ (PGE₂), neuropeptide Y (NPY), and nerve growth factor (NGF) were measured before entering the operating room and 12 hours postoperatively, and adverse reactions were recorded.【Results】 There were no significant differences between the two groups in terms of puncture time, block completion time, surgical duration, and femoral nerve recovery time (P>0.05). Intraoperative sufentanil consumption was significantly lower in the observation group than in the control group (P<0.05). No significant differences were observed in MAP and HR between the two groups at each time point (P>0.05); however, MAP and HR at T₂ in the observation group were significantly lower than those at T₀ and T₁ within the same group (P<0.05). The excellent-to-good anesthesia rate was significantly higher in the observation group (98.33%) than in the control group (88.33%) (P<0.05). Serum PGE₂, NPY, and NGF levels at 12 hours postoperatively were higher than preoperative levels in both groups (P<0.05), but they were significantly lower in the observation group than in the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05).【Conclusion】 Ultrasound-guided modified LPB in THA provides effective anesthesia, reduces opioid consumption, and improves postoperative analgesia.

Key words： Arthroplasty, Replacement, Hip Nerve Block Ultrasonography

收稿日期: 2024-09-08

中图分类号:

R681.8

引用本文:

刘勇斌, 马鹏, 王仁军. 超声引导下改良腰丛神经阻滞用于人工全髋关节置换术中的效果[J]. 医学临床研究, 2026, 43(2): 201-204.
LIU Yongbin, MA Peng, WANG Renjun. Effect of Ultrasound-Guided Modified Lumbar Plexus Block in Total Hip Arthroplasty. JOURNAL OF CLINICAL RESEARCH, 2026, 43(2): 201-204.

链接本文:

http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2026.02.007 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2026/V43/I2/201

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