首页|腹股沟韧带上髂筋膜阻滞对膝关节镜手术止血带的反应影响

腹股沟韧带上髂筋膜阻滞对膝关节镜手术止血带的反应影响

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目的:探讨腹股沟韧带上髂筋膜阻滞对膝关节镜手术中止血带应用的不良生理反应影响。方法:选取 2022 年6 月—2023 年 12 月泗阳医院 72 例接受膝关节镜手术治疗的患者作为研究对象,根据来院先后顺序分为阻滞组和对照组,每组各 36 例,阻滞组采用腹股沟韧带上髂筋膜阻滞联合全麻治疗,对照组采用常规全麻治疗。比较两组在使用止血带前(T0)、使用止血带后 30 min(T1)、60 min(T2)、90 min(T3)以及撤除止血带后 5 min(T4)时的生命体征(平均动脉压、心率)、生化指标[肿瘤坏死因子-α(TNF-α)、丙二醛(MDA)、超氧化物歧化酶(SOD)和乳酸(Lac)]以及疼痛视觉模拟量表(VAS)评分(术后 1 h、12 h、24 h)、不良反应情况和止血带反应相关症状发生率。结果:阻滞组在T1 至T3 时间点的平均动脉压和心率更低,差异有统计学意义(P<0。05);阻滞组术后TNF-α、MDA水平低于对照组,而SOD活性高于对照组,差异有统计学意义(P<0。05);阻滞组术后 24 h和 48 h的疼痛程度低于对照组,阻滞组止血带反应相关症状发生率低于对照组,差异有统计学意义(P<0。05);两组不良反应发生率比较,差异无统计学意义(P>0。05)。结论:腹股沟韧带上髂筋膜阻滞能有效减轻膝关节镜手术中止血带使用的生理反应,降低手术后的疼痛感和不良反应,可提高患者的术后舒适度和安全性。
The Influence of Ilioinguinal Ligament Iliofascial Block on Tourniquet Reaction During Knee Arthroscopy Surgery
Objective:To explore the effect of ilioinguinal ligament iliofascial block on the adverse physiological reactions caused by the use of tourniquets during knee arthroscopy surgery.Method:A total of 72 patients who underwent knee arthroscopy surgery at Siyang Hospital from June 2022 to December 2023 were selected as the study objects and divided into the block group and the control group according to the order of admission,with 36 cases in each group.The block group received ilioinguinal ligament iliofascial block combined with general anesthesia,while the control group received conventional general anesthesia.The vital signs(mean arterial pressure,heart rate),biochemical indicators[tumor necrosis factor-alpha(TNF-α),malondialdehyde(MDA),superoxide dismutase(SOD),and lactate(Lac)],visual analogue scale(VAS)scores(1 h,12 h,24 h post-operation),adverse reactions and the incidence of symptoms associated with tourniquet reactions were compared before tourniquet application(T0),30 minutes(T1),60 minutes(T2),90 minutes(T3)after tourniquet application,and 5 minutes after tourniquet release(T4).Result:The mean arterial pressure and heart rate of the block group at T1 to T3 time points were lower,and the difference was statistically significant(P<0.05).Postoperative levels of TNF-α and MDA in the block group were lower than those in the control group,while SOD activity in the block group was significantly higher than that in the control group,with statistical significance(P<0.05).The pain levels at 24 h and 48 h post-operation in the block group were significantly lower than those in the control group,and the incidence of tourniquet reaction-related symptoms in the control group was lower that in the block group,with statistical significance(P<0.05).There was no significant difference in the comparison of incidence of adverse reactions between the two groups(P>0.05).Conclusion:Ilioinguinal ligament iliofascial block can effectively reduce the physiological reactions to tourniquet use during knee arthroscopy surgery,decrease postoperative pain and adverse reactions,and improve postoperative comfort and safety for patients.

Iliofascial blockKnee arthroscopy surgeryTourniquet reactionAnesthesia

陈云、徐向阳、陈莹、李前胜

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泗阳医院 江苏 泗阳 223700

髂筋膜阻滞 膝关节镜手术 止血带反应 麻醉

2024

中外医学研究
中国医院管理杂志社

中外医学研究

影响因子:1.149
ISSN:1674-6805
年,卷(期):2024.22(36)