临床和实验医学杂志
臨床和實驗醫學雜誌
림상화실험의학잡지
JOURNAL OF CLINICAL AND EXPERIMENTAL MEDICINE
2014年
9期
756-759
,共4页
老年人%股骨上段骨折%腰丛-坐骨神经联合阻滞%感觉神经%运动神经
老年人%股骨上段骨摺%腰叢-坐骨神經聯閤阻滯%感覺神經%運動神經
노년인%고골상단골절%요총-좌골신경연합조체%감각신경%운동신경
Elderly%Femur fracture%Lumbar plexus joint sciatic nerve block%Sensory nerve%Motor nerve
目的：探讨腰丛-坐骨神经联合阻滞用于老年患者股骨上段骨折手术的效果。方法选择80例老年股骨上段骨折患者，按入院顺序随机平均分为两组各40例，研究组患者使用腰丛-坐骨神经联合阻滞进行术前麻醉，对照组患者使用硬膜外术前麻醉。比较两组患者麻醉前后血压及心率变化情况及感觉、运动神经阻滞情况。结果研究组患者收缩压（ SBP）、舒张压（ DBP）及心率（ HR）在麻醉前后变化不明显（ P ﹥0.05），而对照组SBP、DBP在麻醉后明显降低，差异具有统计学意义（ P <0.05），且明显低于研究组；两组患者感觉、运动神经阻滞起效时间及感觉阻滞达最高层面所用时间比较，差异无统计学意义（ P ﹥0.05），研究组感觉神经阻滞持续时间（448.4±112.3 min）明显长于对照组（224.5±102.4 min），且其运动阻滞维持时间（197.4±70.2 min）明显低于对照组（254.6±90.6 min），差异具有统计学意义（ P <0.05）。结论腰丛-坐骨神经联合阻滞对老年患者股骨上段骨折手术麻醉效果显著，安全可靠，值得临床推广应用。
目的：探討腰叢-坐骨神經聯閤阻滯用于老年患者股骨上段骨摺手術的效果。方法選擇80例老年股骨上段骨摺患者，按入院順序隨機平均分為兩組各40例，研究組患者使用腰叢-坐骨神經聯閤阻滯進行術前痳醉，對照組患者使用硬膜外術前痳醉。比較兩組患者痳醉前後血壓及心率變化情況及感覺、運動神經阻滯情況。結果研究組患者收縮壓（ SBP）、舒張壓（ DBP）及心率（ HR）在痳醉前後變化不明顯（ P ﹥0.05），而對照組SBP、DBP在痳醉後明顯降低，差異具有統計學意義（ P <0.05），且明顯低于研究組；兩組患者感覺、運動神經阻滯起效時間及感覺阻滯達最高層麵所用時間比較，差異無統計學意義（ P ﹥0.05），研究組感覺神經阻滯持續時間（448.4±112.3 min）明顯長于對照組（224.5±102.4 min），且其運動阻滯維持時間（197.4±70.2 min）明顯低于對照組（254.6±90.6 min），差異具有統計學意義（ P <0.05）。結論腰叢-坐骨神經聯閤阻滯對老年患者股骨上段骨摺手術痳醉效果顯著，安全可靠，值得臨床推廣應用。
목적：탐토요총-좌골신경연합조체용우노년환자고골상단골절수술적효과。방법선택80례노년고골상단골절환자，안입원순서수궤평균분위량조각40례，연구조환자사용요총-좌골신경연합조체진행술전마취，대조조환자사용경막외술전마취。비교량조환자마취전후혈압급심솔변화정황급감각、운동신경조체정황。결과연구조환자수축압（ SBP）、서장압（ DBP）급심솔（ HR）재마취전후변화불명현（ P ﹥0.05），이대조조SBP、DBP재마취후명현강저，차이구유통계학의의（ P <0.05），차명현저우연구조；량조환자감각、운동신경조체기효시간급감각조체체최고층면소용시간비교，차이무통계학의의（ P ﹥0.05），연구조감각신경조체지속시간（448.4±112.3 min）명현장우대조조（224.5±102.4 min），차기운동조체유지시간（197.4±70.2 min）명현저우대조조（254.6±90.6 min），차이구유통계학의의（ P <0.05）。결론요총-좌골신경연합조체대노년환자고골상단골절수술마취효과현저，안전가고，치득림상추엄응용。
Objective To investigate the effect of lumbar plexus joint sciatic nerve block for femoral fractures surgery in elderly pa-tients. Methods 80 cases of elderly patients with fractures of the upper femur in our hospital were randomly divided into two groups of 40 cases according to the order of admission patients. The study group patients received lumbar plexus joint sciatic nerve block for anesthesia preoperative while the control group received epidural anesthesia. The blood pressure,heart rate changes and sensory and motor nerve block situation were compared between the two groups of patients before and after anesthesia. Results The study group patients′SBP,DBP and HR did not change significantly before and after anesthesia( P ﹥0. 05),while the control group′s SBP,DBP decreased after anesthesia. The difference was statistically significant( P <0. 05),and which was significantly lower than study group. The two groups of patients′feeling,motor nerve block onset time and reached the highest level of sensory block time was not statistically significant difference( P ﹥0. 05). The study group′s duration of sensory block was(448. 4 ± 112. 3 )min,which was significantly longer than the control group′s (224. 5 ± 102. 4)min. Its motor nerve block duration was(197. 4 ± 70. 2)min,which was significantly lower than the control group′s (254. 6 ± 90. 6)min. The difference was statistically significant( P <0. 05). Conclusion The lumbar plexus joint sciatic nerve block anesthesia has a remarkable effect,safe and reliable on upper femoral fractures in elderly patients which is worthy of clinical application.
