全身麻醉与超声引导区域神经阻滞对高龄股骨头置换术患者心肺功能的影响

Effects of General Anesthesia and Ultrasound-guided Regional Nerve Block on Cardiopulmonary Function of Elderly Patients Undergoing Femoral Head Replacement

目的探讨全身麻醉与超声引导区域神经阻滞对高龄股骨头置换术患者心肺功能的影响。方法方便选取2016年1月—2019年10月于贵港市人民医院行股骨头置换术高龄患者66例,随机数字表法分为观察组和对照组,均33例;观察组给予超声引导区域神经阻滞,对照组行全身静脉麻醉;观察两组患者术后1 d心功能相关指标HR、MAP,肺功能相关指标FEV1/FEV、RV/TLC及心血管不良事件发生率。结果对照组术后1 d HR、MAP、FEV1/FEV及RV/TLC分别为(93.67±9.48)次/min、(106.73±9.16)mmHg、(64.05±5.82)%、(45.34±6.21)%,观察组术后1 d上述指标分别为(86.44±7.37)次/min、(93.67±8.46)mmHg、(76.34±9.64)%、(36.28±4.01)%;与对照组相比,术后1 d观察组HR、MAP及RV/TLC值降低,FEV1/FEV值升高,差异有统计学意义(t=3.460、6.020、7.040、6.270,P<0.05);观察组围手术期心动过速、无症状性心肌缺血、心绞痛发生率分别为12.12%、18.18%、15.15%,低于对照组48.48%、48.48%、36.36%,差异有统计学意义(χ^(2)=10.330、6.818、4.889,P<0.05)。结论超声引导区域神经阻滞对高龄股骨头置换术患者心肺功能影响较低,有利于高龄患者术后恢复。

Objective To investigate the effect of general anesthesia and ultrasound-guided regional nerve block on the cardiopulmonary function of elderly patients undergoing femoral head replacement.Methods From January 2016 to October 2019,66 elderly patients underwent femoral head replacement at Guigang People’s Hospital were convenient selected.They were randomly divided into observation group and control group with 33 cases in each group.The observation group was given ultrasound-guided regional nerve block.The control group underwent general intravenous anesthesia;the cardiac function-related indexes HR,MAP,lung function-related indexes FEV1/FEV,RV/TLC and the incidence of adverse cardiovascular events were observed in the two groups at 1 day after operation.Results HR,MAP,FEV1/FEV and RV/TLC were(93.67±9.48)times/min,(106.73±9.16)mmHg,(64.05±5.82)%and(45.34±6.21)%in the control group,and(86.44±7.37)times/min,(93.67±8.46)mmHg,(76.34±9.64)and(36.28±4.01)in the observation group.Compared with the control group,HR,MAP and RV/TLC values were decreased and EFV1/FEV1 values were increased in the observation group 1 day after surgery,with statistically significant differences(t=3.460,6.020,7.040,6.270,P<0.05);the incidences of tachycardia,asymptomatic myocardial ischemia,and angina pectoris in the observation group were 12.12%,18.18%,and 15.15%,respectively,lower than those in the control group(48.48%,48.48%,and 36.36%),and the difference was statistically significant(χ^(2)=10.330,6.818,4.889,P<0.05).Conclusion Ultrasound-guided regional nerve block has a lower effect on the cardiopulmonary function of elderly patients undergoing femoral head replacement,which is beneficial to the recovery of elderly patients after surgery.