腰丛联合坐骨神经阻滞在高龄下肢手术患者中的应用研究

Application Research on Lumbar Plexus Combined with Sciatic Nerve Block in the Elderly Patients with Low Extremity Operation

目的探究腰丛联合坐骨神经阻滞在高龄下肢手术患者中的应用效果。方法该研究整群选取2014年1月1日—12月31日在该科室进行下肢手术的高龄患者68例分为A组及B组,A组进行腰丛联合坐骨神经阻滞;B组进行腰硬联合麻醉。对比两组患者SBP、DBP及HR,感觉与运动阻滞时间等相关指标数据。结果结果显示,A组、B组分别进行组内比较发现,与给药前相比,给药15、30、60 min时患者SBP、DBP及HR均明显改善,差异有统计学意义,P<0.05;给药60 min时A组患者SBP、DBP及HR数据分别为(149.4±38.4)mm Hg、(82.5±10.6)mm Hg、(72.1±14.2)次/min,明显优于B组对应指标数据(135.1±40.1)mm Hg、(60.1±10.2)mm Hg、(79.1±14.5)次/min,差异有统计学意义,P<0.05。对比两组患者感觉与运动阻滞时间发现,A组感觉与运动阻滞起效时间,达到峰值时间均晚于B组(P<0.05),且有效阻滞时间长于B组(P<0.05)。差异有统计学意义,P<0.05。结论采用腰丛联合坐骨神经阻滞对高龄下肢手术患者进行麻醉,效果较好,且安全性较高。

Objective To discuss the application effect of lumbar plexus combined with sciatic nerve block in the elderly patients with low extremity operation. Methods 68 cases of elderly patients receiving low extremity operation in our department of our hospital from January 1, 2014 to December 31, 2014 were selected and divided into two groups, the group A were given lumbar plexus combined with sciatic nerve block, the group B were given combined spinal-epidural anaesthesia,the relevant index data such as SBP, DBP, HR, sense and motor block time of the two groups were compared. Results The SBP, DBP and HR in patients were obviously improved at 15 min, 30 min and 60 min after administration compared with those before administration in both group A and group B, and the difference was obvious with statistical significance, P〈0.05, the differences in the SBP, DBP and HR at 60 min after administration between the group A and the group B were obvious with statistical significance（149.4±38.4） mm Hg,（82.5±10.6） mm Hg,（72.1±14.2）/min vs（135.1±40.1） mm Hg,（60.1±10.2）mm Hg,（79.1±14.5）/min, P〈0.05, the time to reach peak time of sense and motor block onset time in the group A was later than that in the group B（P〈0.05）, the effective block time in the group A was longer than that in the group B,（P〈0.05）, and the differences were obvious with statistical significance, P〈0.05.Conclusion The application of lumbar plexus combined with sciatic nerve block in the anaesthesia of elderly patients with low extremity operation has a good effect and high security.