CAJ | 학술논문

目的：：探讨神经刺激仪引导下神经阻滞麻醉在老年高危病人髋关节手术中的应用价值。方法：将拟行髋关节手术的46例病人纳入本组研究对象，纳入者均为老年高危病人，按信封法随机分为两组，即对照组(硬膜外麻醉组)和观察组(神经刺激仪引导下椎旁联合腰丛-坐骨神经阻滞组)，每组23例；记录两组神经阻滞起效时间、入室后(T0)、手术开始即刻(T1)、开始后10min(T2)、30min(T3)及术毕(T4)各时点的血流动力学变化；并对两组麻醉效果及围术期不适反应进行评估。结果：与对照组比较，观察组感觉、运动神经阻滞起效时间短(P <0.05)，与 T0时比较，观察组 T1~T4各时点血流动力学变化更为平稳(P <0.05)；两组在麻醉效果近似的基础上，观察组在围术期不适反应发生率明显低于对照组(P <0.05)。结论：神经刺激仪引导下神经阻滞可以帮助麻醉医师精确定位，用于老年高危病人全髋关节置换术，麻醉效果可以满足需要且对生理功能干扰小，值得临床推广应用。
목적：：탐토신경자격의인도하신경조체마취재노년고위병인관관절수술중적응용개치。방법：장의행관관절수술적46례병인납입본조연구대상，납입자균위노년고위병인，안신봉법수궤분위량조，즉대조조(경막외마취조)화관찰조(신경자격의인도하추방연합요총-좌골신경조체조)，매조23례；기록량조신경조체기효시간、입실후(T0)、수술개시즉각(T1)、개시후10min(T2)、30min(T3)급술필(T4)각시점적혈류동역학변화；병대량조마취효과급위술기불괄반응진행평고。결과：여대조조비교，관찰조감각、운동신경조체기효시간단(P <0.05)，여 T0시비교，관찰조 T1~T4각시점혈류동역학변화경위평은(P <0.05)；량조재마취효과근사적기출상，관찰조재위술기불괄반응발생솔명현저우대조조(P <0.05)。결론：신경자격의인도하신경조체가이방조마취의사정학정위，용우노년고위병인전관관절치환술，마취효과가이만족수요차대생리공능간우소，치득림상추엄응용。
Objective:To study the application value of nerve block guided by nerve stimulator used in total hip replacement in elderly patients with high-risk.Methods:46 hip surgery patients were included in this research object,all of them were elderly patients with high risk.According to the envelope method they were randomly divided into two groups, named control group (epidural anesthesia group )and observation group (nerve stimulator guided by the vertebral joint lumbar plexus and sciatic nerve block group),23 cases in each one.Two groups of nerve block,home after work time (T0),surgery (T1),immediately began after 10min (T2 ),30min (T3 ) and finish the hemodynamic changes of each point were recorded.And the effects of two groups of anesthesia and perioperative reaction were evaluated. Results:Compared with control group,the observation group of sensory and motor nerve block had shorter effective time (P <0.05).Compared with the T0,observation group T1 ~4 point hemodynamic changes was more smoothly (P < 0.05 );On the basis of similar anesthesia effect,the observation group had significantly lower incidence of discomfort reaction in perioperative than the control group (P <0.05).Conclusion:The nerve block guided by nerve stimulator can help anesthesiologists pinpoint position,and used for high-risk patients with total hip replacement in old age.Its anesthetic effect can meet the needs and have little interference on physiological function.