股骨颈骨折手术治疗中采取腰丛-坐骨神经阻滞与全身麻醉对血流动力学的影响

Effect of lumbar plexus-sciatic nerve block and general anesthesia on hemodynamics in surgical treatment of femoral neck fracture

目的 探究股骨颈骨折手术治疗中采取腰丛-坐骨神经阻滞与全身麻醉对血流动力学的影响。方法 64例进行股骨颈骨折手术治疗的患者,随机分为对照组和观察组,每组32例。对照组患者接受全身麻醉,观察组患者接受腰丛-坐骨神经阻滞麻醉。对比两组患者不同时间(麻醉前及麻醉后15、30、60、90 min)的舒张压、收缩压、心率。结果 麻醉前及麻醉后15 min,两组患者的舒张压、收缩压、心率比较,差异均无统计学意义(P>0.05);麻醉后30、60、90 min,观察组患者的收缩压分别为(135.96±10.56)、(132.58±12.47)、(133.85±10.42)mm Hg(1 mm Hg=0.133 kPa),均高于对照组的(120.56±9.85)、(120.42±10.49)、(122.52±11.25)mm Hg,差异具有统计学意义(P<0.05)。麻醉后30、60、90 min,观察组患者的舒张压分别(80.20±6.22)、(78.59±5.12)、(79.53±6.45)mm Hg,高于对照组的(65.26±7.82)、(71.53±6.20)、(72.42±6.80)mm Hg,差异具有统计学意义(P<0.05)。麻醉后30、60、90 min,观察组患者的心率分别为(77.06±2.42)、(77.50±2.74)、(77.22±1.86)次/min,均高于对照组的(75.41±2.50)、(75.82±2.26)、(75.78±2.23)次/min,差异具有统计学意义(P<0.05)。结论 在给予股骨颈骨折手术治疗的患者麻醉时,相比于全身麻醉,采取腰丛-坐骨神经阻滞更能提高临床麻醉效果,患者的舒张压、收缩压以及心率更加稳定,提示该麻醉方案可在临床中推崇。

Objective To investigate the effect of lumbar plexus-sciatic nerve block and general anesthesia on hemodynamics in surgical treatment of femoral neck fracture.Methods A total of 64 patients who underwent surgical treatment of femoral neck fractures were randomly divided into control group and observation group,with 32 cases in each group.The control group received general anesthesia,and the observation group received lumbar plexus-sciatic nerve block anesthesia.The diastolic blood pressure,systolic blood pressure,and heart rate at different time points(before anesthesia and 15,30,60,90 min after anesthesia) were compared between the two groups.Results Before anesthesia and 15 min after anesthesia,there was no statistically significant difference in diastolic blood pressure,systolic blood pressure,and heart rate between the two groups(P>0.05).30,60,90 min after anesthesia,the systolic blood pressure of the observation group were(135.96±10.56),(132.58±12.47) and(133.85±10.42) mm Hg(1 mm Hg=0.133 kPa),which were all higher than(120.56±9.85),(120.42±10.49) and(122.52±11.25) mm Hg of the control group,and the difference was statistically significant(P<0.05).30,60,90 min after anesthesia,the diastolic blood pressure of the observation group were(80.20±6.22),(78.59±5.12) and(79.53±6.45) mm Hg,which were higher than(65.26±7.82),(71.53±6.20) and(72.42±6.80) mm Hg of the control group,and the difference was statistically significant(P<0.05).30,60,90 min after anesthesia,the heart rates of the observation group were(77.06±2.42),(77.50±2.74) and(77.22±1.86) beats/min,which were higher than(75.41±2.50),(75.82±2.26) and(75.78±2.23) beats/min of the control group,and the difference was statistically significant(P<0.05).Conclusion Compared with general anesthesia,lumbar plexussciatic nerve block can improve the clinical anesthesia effect,and the diastolic blood pressure,systolic blood pressure and heart rate of patients are more stable,which suggests that this anesthesia scheme can be promoted in clinical practice.