目的:探究腹股沟韧带上髂筋膜间隙与骶丛神经阻滞在老年股骨粗隆间骨折手术中的应用价值。方法:选取2022 年 8 月—2023 年 8 月于黄石工矿医院进行股骨粗隆间骨折手术治疗的 66 例老年患者作为研究对象，采用随机数表法将患者分为常规阻滞组(腰交感神经阻滞)和联合阻滞组(腹股沟韧带上髂筋膜间隙联合骶丛神经阻滞)，各 33 例。比较两组术中相关指标、麻醉满意度、疼痛程度及不良反应。结果:联合阻滞组感觉和运动阻滞起效时间和完全时间长于常规阻滞组，麻醉满意度高于常规阻滞组，差异有统计学意义(P<0。05)。联合阻滞组手术切皮即刻和手术结束即刻视觉模拟评分法(VAS)评分高于常规阻滞组，而术后 24 h VAS评分低于常规阻滞组，差异有统计学意义(P<0。05);但两组手术开始后 30 min VAS评分比较，差异无统计学意义(P>0。05)。联合阻滞组头痛、恶心、呕吐及尿潴留发生率低于常规阻滞组，差异有统计学意义(P<0。05);两组均未发生严重并发症。结论:老年股骨粗隆间骨折手术患者给予腹股沟韧带上髂筋膜间隙联合骶丛神经阻滞，可提升镇痛、镇静效果，提升麻醉满意度，并减少术后不良反应。
Application of Iliac Fascia Space On Inguinal Ligament Combined with Sacral Plexus Block in Surgery for Intertrochanteric Fracture of Femur in Elderly Patients
Objective:To explore the application of iliac fascia space on inguinal ligament combined with sacral plexus block in surgery for intertrochanteric fracture of femur in elderly patients.Method:A total of 66 elderly patients who underwent surgical treatment of intertrochanteric fracture of femur in Huangshi Industrial and Mining Hospital from August 2022 to August 2023 were selected as the research objects,the patients were divided into the conventional block group(lumbar sympathetic nerve block)and the combined block group(iliac fascia space on inguinal ligament combined with sacral plexus block)by random number table method,with 33 cases in each group.The intraoperative related indicators,anesthesia satisfaction,pain degree and adverse reactions were compared between two groups.Result:The onset time and complete time of sensory and motor block in the combined block group were longer than those in the conventional block group,and the anesthesia satisfaction was higher than that in the conventional block group,the differences were statistically significant(P<0.05).The visual analogue scale(VAS)scores of the combined block group immediately after skin incision and at the end of operation were higher than those of the conventional block group,while the VAS score at 24 h after operation was lower than that of the conventional block group,and the differences were statistically significant(P<0.05);however,there were no significant differences in VAS scores between two groups at 30 min after the start of surgery(P>0.05).The incidence of headache,nausea,vomiting and urinary retention in the combined block group were lower than those in the conventional block group,and the differences were statistically significant(P<0.05);no serious complications occurred in two groups.Conclusion:Iliac fascia space on inguinal ligament combined with sacral plexus block in surgery for intertrochanteric fracture of femur in elderly patients can improve the analgesic and sedative effects,improve anesthesia satisfaction,and reduce postoperative adverse reactions.
Intertrochanteric fracture of femurElderlyIliac fascia space on inguinal ligament combined with sacral plexus blockLumbar sympathetic ganglion block
万方数据
维普
