超声引导下高位髂筋膜阻滞对老年患者股骨头置换术后凝血功能的研究
DOI:
作者:
作者单位:

南京市江宁医院

作者简介:

通讯作者:

中图分类号:

基金项目:

2022年度江苏医药职业学院校外教学基地科研发展专项课题 编号20229141


Study on coagulation function of senile patients after femoral head replacement under high iliac fascia block guided by ultrasound
Author:
Affiliation:

Jiangning Hospital

Fund Project:

  • 摘要
  • |
  • 图/表
  • |
  • 访问统计
  • |
  • 参考文献
  • |
  • 相似文献
  • |
  • 引证文献
  • |
  • 资源附件
  • |
  • 文章评论
    摘要:

    摘要:目的:探讨超声引导高位髂筋膜阻滞对股骨头置换老年患者凝血功能的影响。方法:选择在静脉全身麻醉下行股骨头置换的老年患者80例。按随机数字表分为2组:观察组(超声引导高位髂筋膜阻滞联合静脉全身麻醉组)在麻醉诱导前30 min行超声引导高位髂筋膜阻滞然后再行静脉全身麻醉;对照组(静脉全身麻醉组)只行静脉全身麻醉,每组40例。分别于入院检查时(基础值)、手术开始后1 h、术后24 h抽取肘静脉血进行血栓弹力图分析;离心分离血清,测定血清皮质醇、C-反应蛋白(CRP)、IL-6、TNF-α水平。记录患者术后6 h(T1)、24 h(T2)、48 h(T3)安静和运动时NRS评分。记录术后不良反应和患者满意度评分。结果:与对照组比较,观察组患者在术后24 h的R值增高, MA、α、CI降低(P<0.05)。与入院时比较,对照组患者术后24 h的R值降低,且MA、α、CI升高(P<0.05)。与对照组相比,观察组患者手术开始后1 h和术后24 h的皮质醇、CRP、IL-6和TNF-α的含量降低(P<0.05),术后T1-T3时点的静息和运动时NRS评分低(P<0.05),满意度高(P<0.05),苏醒期躁动和恶心呕吐的发生率低(P<0.05)。结论:超声引导高位髂筋膜阻滞联合全身麻醉能降低老年患者行股骨头置换术中和术后的应激反应和高凝状态,提供较好的术后镇痛效果。

    Abstract:

    Objective: To investigate the effect of ultrasound-guided high iliac fascia block on blood coagulation in elderly patients with femoral head replacement. Methods: Eighty elderly patients undergoing femoral head replacement under intravenous general anesthesia were selected. The patients were divided into two groups according to the random number table: observation group (ultrasound-guided high fascia iliac block combined with intravenous general anesthesia group) underwent ultrasound-guided high fascia iliac block followed by intravenous general anesthesia 30 min before anesthesia induction; The control group (intravenous general anesthesia group) only received intravenous general anesthesia, with 40 cases in each group. Venous blood samples were collected at admission (baseline), 1 h and 24 h after operation for thromboelastography analysis. Serum was separated by centrifugation, and the levels of serum cortisol, C-reactive protein (CRP), IL-6 and TNF-α were determined. NRS scores were recorded at 6 h (T1), 24 h (T2) and 48 h (T3) after operation. Postoperative adverse reactions and patient satisfaction scores were recorded. Results: Compared with the control group, the R value of the observation group was increased at 24 h after operation, and MA, α and CI were decreased(P<0.05). Compared with those at admission, the R value of the control group at 24 hours after operation was decreased, and MA, α, and CI were increased(P<0.05). Compared with the control group, the contents of cortisol, CRP, IL-6 and TNF-α at 1 h and 24 h after operation in the observation group were decreased (P<0.05), the NRS scores at rest and during exercise at T1-T3 after operation were lower(P<0.05), and the satisfaction degree was higher(P<0.05). The incidence of restlessness, nausea and vomiting during the recovery period was low(P<0.05).Conclusions: Ultrasound-guided high fascia iliaca block combined with general anesthesia can reduce the stress response and hypercoagulable state during and after femoral head replacement in elderly patients, and provide better postoperative analgesia.

    参考文献
    相似文献
    引证文献
引用本文
分享
文章指标
  • 点击次数:
  • 下载次数:
  • HTML阅读次数:
  • 引用次数:
历史
  • 收稿日期:2023-05-13
  • 最后修改日期:2023-06-17
  • 录用日期:2023-10-25
  • 在线发布日期:
  • 出版日期: