股骨上段骨折术中神经阻滞的方法及作用

Method and Effect of Nerve Block in the Operation of Upper Femoral Fractures

目的探讨超声及神经刺激仪的双重引导下多点式神经阻滞在股骨上段骨折术中的作用。方法将141例股骨上段骨折患者随机分为U组、N组、UN组。3组术中均实施多点式腰丛-坐骨神经阻滞,其中U组在超声引导下进行,N组在神经刺激仪引导下进行,UN组在超声、神经刺激仪双重引导下进行。结果UN组感觉阻滞起效时间、运动阻滞起效时间均短于N组和U组,N组均短于U组,差异均有统计学意义(P<0.05);UN组感觉阻滞持续时间、运动阻滞持续时间均长于N组和U组,N组均长于U组,差异均有统计学意义(P<0.05)。结论在股骨上段骨折术中采用双重引导下多点式神经阻滞不会明显延长神经阻滞操作时间,可提高神经阻滞效果。

Objective To explore the role of multi-point nerve block under the dual guidance of ultrasound and nerve stimulator in the operation of upper femoral fracture.Methods 141 patients with upper femoral fractures were randomly divided into U group,N group and UN group.All three groups underwent multi-point lumbar plexus-sciatic nerve block.U group was guided by ultrasound,N group was guided by nerve stimulator,and UN group was guided by ultrasound and nerve stimulator.Results The onset time of sensory block and the onset time of exercise block in the UN group were shorter than those in the N group and U group,and the N group was shorter than the U group.The differences were statistically significant(P<0.05);The duration of stagnation and the duration of exercise block were longer than those in group N and U,and group N was longer than group U.The differences were statistically significant(P<0.05).Conclusion The use of double-guided multi-point nerve block in the operation of upper femoral fractures will not significantly prolong the operation time of nerve block,and can improve the effect of nerve block.