分析星状神经节阻滞对老年髋关节置换术患者术后睡眠及谵妄的影响
Analysis of the Effects of Stellate Ganglion Block on Postoperative Sleep and Delirium in Elderly Patients Undergoing Hip Replacement Surgery
庄伟强 1张亮 1吴竑鹏 1谢文吉 2陈晓阳1
作者信息
- 1. 福建省泉州市惠安县医院,泉州,362100
- 2. 福建医科大学附属泉州第一医院,泉州,362000
- 折叠
摘要
目的:研究星状神经节阻滞(SGB)对老年髋关节置换术(THA)患者术后睡眠及谵妄的影响.方法:选取2020 年 1月至2023 年3 月福建省泉州市惠安县医院内行髋关节置换术的老年患者 84 例作为研究对象,按照随机数字表法分为对照组和观察组,每组42 例,2 组均行腰硬联合阻滞麻醉,观察组同时行右侧星状神经节阻滞治疗.比较 2 组患者的术中情况,记录2 组手术时间、术中出血量、术中输液量,采用匹兹堡睡眠质量指数(PSQI)比较2 组患者干预前后睡眠质量的变化,采用视觉模拟评分法(VAS)比较2 组患者干预前后的疼痛感受,并比较2 组患者术后睡眠障碍(POSD)及术后谵妄(POD)的发生率.结果:观察组术后当天、术后第 1 天的PSQI得分显著低于对照组,观察组在术后当天、术后第 1天的POSD发生率和POD发生率均显著低于对照组,观察组在术后当天、术后第 1 天的VAS评分显著低于对照组,差异有统计学意义(P＜0.05).结论:SGB在老年THA中的应用效果显著,可有效改善患者睡眠质量,对降低POSD、POD发生率有积极作用,并减轻了术后疼痛,有利于加快康复进程,值得推广应用.
Abstract
Objective:To investigate the effects of stellate ganglion block(SGB)on postoperative sleep and delirium in elderly patients undergoing hip arthroplasty(THA).Methods:A total of 84 elderly patients who underwent hip replacement surgery in Hui'an County Hospital,Quanzhou City,Fujian Province from January 2020 to March 2023 were selected as the study sub-jects.They were randomly divided into an observation group(n =42)and a control group(n =42)using a random number table method.Both groups received combined lumbar epidural block anesthesia,while the observation group received right stellate gan-glion block treatment simultaneously.Compare the intraoperative conditions of two groups of patients,record the surgical time,intr-aoperative blood loss,and intraoperative infusion volume,use the Pittsburgh Sleep Quality Index(PSQI)to compare the changes in sleep quality before and after intervention,use the Visual Analog Scale(VAS)to compare the pain sensation of the two groups of patients before and after intervention,and compare the incidence of postoperative sleep disorders(POSD)and postoperative deliri-um(POD)between the two groups of patients.Results:The PSQI scores of the observation group were significantly lower than those of the control group on the day after surgery and the first day after surgery.The incidence of POSD and POD in the observa-tion group was significantly lower than that of the control group on the day after surgery and the first day after surgery.The VAS scores of the observation group on the day after surgery and the first day after surgery were significantly lower than those of the control group,and the difference between the two groups was statistically significant(P＜0.05).Conclusion:The application effect of SGB in elderly patients with THA is significant,which can effectively improve the sleep quality of patients,have a positive effect on reducing the incidence of POSD and POD,and alleviate postoperative pain.It is conducive to accelerating the recovery process and is worthy of promotion and application.
关键词
星状神经节阻滞/腰硬联合麻醉/老年患者/髋关节置换术/睡眠质量/睡眠障碍/术后谵妄/疼痛程度Key words
Stellate ganglion block/Combined spinal epidural anesthesia/Elderly patients/Hip replacement surgery/Sleep quality/Sleep disorders/Postoperative delirium/Pain level引用本文复制引用
出版年
2024
国家科技期刊平台
NSTL
万方数据