中国当代医药
中國噹代醫藥
중국당대의약
China Modern Medicine
2015年
26期
122-124
,共3页
超声%股神经%镇痛%膝关节
超聲%股神經%鎮痛%膝關節
초성%고신경%진통%슬관절
Ultrasonic%Femoral nerve%Analgesia%Knee joint
目的：探讨超声平面内定位股神经阻滞镇痛在老年患者全膝关节置换术(TKA)中的应用效果。方法选取本院2013年1月~2015年1月行TKA术的60例老年患者作为研究对象，按照随机数字表法分为超声定位股神经组(U组)，股神经阻滞组(F组)，腰麻对照组(C组)，各20例。 U组采用超声定位股神经，平面内穿刺置管股神经阻滞，术后镇痛；F组采用解剖定位股神经穿刺置管，股神经阻滞，术后镇痛；C组采用蛛网膜下腔麻醉，术后应用静脉镇痛。比较3组的操作起效时间，术中麻醉效果，术后1、6、12、24、48 h的疼痛评分(VAS)，外周血5-羟色胺(5-HT)浓度及患者按压镇痛泵次数。结果 U组术后6、12、24 h的VAS评分显著低于C组和F组，差异有统计学意义(P<0.05)。U组术后6、12、24 h的5-HT浓度显著低于C组和F组，差异有统计学意义(P<0.05)。U组的操作时间显著短于F组，差异有统计学意义(P<0.05)。 U组的按压次数显著低于C组和F组，差异有统计学意义(P<0.05)。结论超声平面内定位行股神经阻滞在老年患者TKA镇痛中的应用效果显著，值得临床推广应用。
目的：探討超聲平麵內定位股神經阻滯鎮痛在老年患者全膝關節置換術(TKA)中的應用效果。方法選取本院2013年1月~2015年1月行TKA術的60例老年患者作為研究對象，按照隨機數字錶法分為超聲定位股神經組(U組)，股神經阻滯組(F組)，腰痳對照組(C組)，各20例。 U組採用超聲定位股神經，平麵內穿刺置管股神經阻滯，術後鎮痛；F組採用解剖定位股神經穿刺置管，股神經阻滯，術後鎮痛；C組採用蛛網膜下腔痳醉，術後應用靜脈鎮痛。比較3組的操作起效時間，術中痳醉效果，術後1、6、12、24、48 h的疼痛評分(VAS)，外週血5-羥色胺(5-HT)濃度及患者按壓鎮痛泵次數。結果 U組術後6、12、24 h的VAS評分顯著低于C組和F組，差異有統計學意義(P<0.05)。U組術後6、12、24 h的5-HT濃度顯著低于C組和F組，差異有統計學意義(P<0.05)。U組的操作時間顯著短于F組，差異有統計學意義(P<0.05)。 U組的按壓次數顯著低于C組和F組，差異有統計學意義(P<0.05)。結論超聲平麵內定位行股神經阻滯在老年患者TKA鎮痛中的應用效果顯著，值得臨床推廣應用。
목적：탐토초성평면내정위고신경조체진통재노년환자전슬관절치환술(TKA)중적응용효과。방법선취본원2013년1월~2015년1월행TKA술적60례노년환자작위연구대상，안조수궤수자표법분위초성정위고신경조(U조)，고신경조체조(F조)，요마대조조(C조)，각20례。 U조채용초성정위고신경，평면내천자치관고신경조체，술후진통；F조채용해부정위고신경천자치관，고신경조체，술후진통；C조채용주망막하강마취，술후응용정맥진통。비교3조적조작기효시간，술중마취효과，술후1、6、12、24、48 h적동통평분(VAS)，외주혈5-간색알(5-HT)농도급환자안압진통빙차수。결과 U조술후6、12、24 h적VAS평분현저저우C조화F조，차이유통계학의의(P<0.05)。U조술후6、12、24 h적5-HT농도현저저우C조화F조，차이유통계학의의(P<0.05)。U조적조작시간현저단우F조，차이유통계학의의(P<0.05)。 U조적안압차수현저저우C조화F조，차이유통계학의의(P<0.05)。결론초성평면내정위행고신경조체재노년환자TKA진통중적응용효과현저，치득림상추엄응용。
Objective To explore the application effect of the ultrasonic plane in the femoral nerve block analgesia in elderly patients with total knee arthroplasty (TKA). Methods 60 elderly patients with TKA from January 2013 to Jan-uary 2015 in our hospital were selected and randomly divided into Ultrasound localization of femoral nerve group (group U),femoral nerve block (group F),lumbar anesthesia group (group C) according to the random number table method,20 cases in each group.Group U was used to locate the femoral nerve,the femoral nerve block and the postoper-ative analgesia.Group F was used to dissect the femoral nerve,femoral nerve block,and postoperative analgesia.Group C was anesthetized with subarachnoid space,and intravenous analgesia was used.The operation work time,intraoperative anesthetic effect,postoperative 1 the score of visual analog scale (VAS) at 6,12,24,48 h,the concentration of peripheral blood 5-(5-HT) and the number of patients with analgesia pump frequency among three groups was compard. Results The score of VAS after operation at 6,12,24 h in group U was lower than group C and group F,with significant differ-ence (P<0.05).The concentration of peripheral blood 5-HT after operation at 6,12,24 h in group U was lower than group C and group F,with significant difference (P<0.05).The operation work time of group U was shorter than that of group F, with significant difference (P<0.05).The number of patients with analgesia pump frequency in group U was lower than group C and group F,with significant difference(P<0.05). Conclusion The application effect of the ultrasonic plane position-ing femoral nerve block in the elderly patients with TKA is significant,it is worthy of clinical promotion and application.
