摘要
目的评价腰丛-坐骨神经阻滞在高龄患者小切口双极人工股骨头置换术中的应用价值。方法选本院高龄患者57例,按照随机数字表法分为腰丛-坐骨神经阻滞组(A组,n=26)和硬腰联合组(B组,n=31),记录两组麻醉前、切皮时、阻滞后10,15,20,25,30 min患者收缩压、舒张压及心率变化,并在各时间点对其进行感觉运动功能评分,记录术中使用的辅助药用量。结果与麻醉前比较,B组切皮时的心率、收缩压、舒张压变化较大(P<0.05),阻滞后10 min,与A组比较,B组血压明显下降,心率加快(P<0.05)。A组的辅助药麻黄碱的用量较B组少(P<0.05)。阻滞后各时间点A组的感觉评分≤2分的比例与B组相比较,差异无统计学意义(P>0.05)。但A组运动评分≤2分的比例则小于B组,差异有统计学意义(P<0.05)。结论腰丛-坐骨神经阻滞血流动力学稳定、效果确切、运动阻滞轻微,适合用于高龄患者微创小切口双极人工股骨头置换术。
Objective To evaluate the clinical value of lumbar plexus-sciatic nerve block for bipolar artificial femoral head replacement in senile patients.Methods According to a random number table,62 elderly cases in our hospital were divided into lumbar plexussciatic nerve block group（group A,n = 31） and epidural anesthesia group（group B,n = 31）.Changes of systolic blood pressure,diastolic blood pressure and heart rate were recorded in two groups before the nerve block,at the time of incision,10,15,20,25,30 min after the nerve block.The sensory and motor function scores were evaluated at each time point.The dosage of auxiliary medicine was recorded. Results At the time of incision,systolic blood pressure and diastolic blood pressure decreased significantly and heart rate increased significantly in group B（P 0 05）.Compared with group A,blood pressure was significantly reduced in group B 10 min after the nerve block,and heart rate incresed（P0.05）.The dosage of ephedrine in group A was significantly less than in group B（P 0.05）.Proportion of sensory scores≤2 in group A at each time point after the block was similar to that in group B,and there was no significant difference（P 0.05）.But the proportion of motor score≤2 points was significantly lower than that in group B（P 0.05）. Conclusion The lumbar plexus-sciatic nerve block has the advantages of stable hemodynamics,exact effect,and less motor block, and may be a better anesthesia way for small incision bipolar artificial femoral head replacement in senile patients.
出处
《山西医科大学学报》
CAS
2013年第5期398-401,共4页
Journal of Shanxi Medical University
关键词
腰丛-坐骨神经阻滞
高龄
小切口双极人工股骨头置换术
lumbar plexus-sciatic nerve block
senile
small incision bipolar artificial femoral head replacement
