老年脊柱畸形患者腹股沟疝手术中采取超声引导下神经阻滞的临床观察

Clinical Observation of Ultrasound-guided Nerve Block during Inguinal Hernia Surgery in Elderly Patients with Spinal Deformity

目的探究超声引导下神经阻滞应用于老年脊柱畸形患者腹股沟疝手术中的效果。方法选取随机该院自2018年9月—2019年8月期间收治的56例行腹股沟疝手术的老年脊柱畸形患者,采取抽签法随机分为试验组(n=28)与参照组(n=28),参照组实施腰硬联合麻醉,试验组实施超声引导下神经阻滞,对比两组患者T0、T1、T2时刻HR、MAP及并发症发生情况。结果T0时刻,两组患者HR及MAP对比差异无统计学分析意义(P>0.05);T1、T2时刻试验组HR为(70.59±6.42)、(71.43±4.57)次/min均低于参照组的(79.65±4.82)、(74.02±4.79)次/min(t=5.972、2.079,P<0.001、0.042),T1、T2时刻试验组MAP为(91.46±8.49)mmHg、(94.71±8.11)mmHg高于参照组的(80.14±8.17)、(89.73±9.84)mmHg(t=6.543、2.066,P<0.001、0.044),试验组并发症发生率为7.14%明显低于参照组的35.71%,差异有统计学意义(χ^(2)=6.788,P=0.009)。结论超声引导下神经阻滞应用于老年脊柱畸形患者腹股沟疝手术中效果显著,安全性高。

Objective To explore the effect of ultrasound-guided nerve block applied in inguinal hernia surgery in elderly patients with spinal deformity.Methods 56 elderly patients with spinal deformity who underwent inguinal hernia surgery admitted to the hospital from September 2018 to August 2019 were randomly selected divided into experimental group(n=28)and reference group(n=28)by lottery method,the reference group was given combined spinal-epidural anesthesia,and the experimental group was given ultrasound-guided nerve block.The HR,MAP and complications at T0,T1,and T2 were compared between the two groups.Results At T0,there was not statistically significant difference in HR and MAP between the two groups of patients(P>0.05);at T1 and T2,the HR of the test group was(70.59±6.42)times/min,and(71.43±4.57)times/min were both lower than The reference group's(79.65±4.82)times/min,(74.02±4.79)times/min(t=5.972,2.079,P=<0.001,0.042),the test group MAP at T1 and T2 was(91.46±8.49)mmHg,(94.71±8.11)mmHg was higher than the reference group(80.14±8.17)mmHg,(89.73±9.84)mmHg(t=6.543,2.066,P<0.001,0.044),the complication rate of the experimental group was 7.14%significantly lower than the reference group 35.71%of the group,the difference was statistically significant(χ^(2)=6.788,P=0.009).Conclusion Ultrasound-guided nerve block applied to inguinal hernia surgery in elderly patients with spinal deformity is effective and safe,and it is worthy of promotion.