超声引导下神经阻滞麻醉对PFNA术后疼痛与T细胞亚群指标的影响

Effect of Ultrasound-guided Nerve Block Anesthesia on Pain and T Cell Subsets after PFNA

目的:研究超声引导下神经阻滞麻醉在股骨近端防旋髓内钉(PFNA)手术中的应用影响。方法:选取2020年6月—2021年6月在无锡新吴华卫医院接受PFNA治疗的88例患者作为研究对象,采用随机数表法分为试验组和对照组,各44例。对照组采用全身麻醉,试验组同时采用超声引导下神经阻滞麻醉。比较两组麻醉效果、术后疼痛、免疫因子水平及安全性情况。结果:试验组苏醒时间、拔除喉罩时间早于对照组,差异有统计学意义(P<0.05);试验组术后6、12、24 h的数字疼痛评定量表(NRS)得分低于对照组,差异有统计学意义(P<0.05);试验组术后的CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)高于对照组,差异有统计学意义(P<0.05);试验组不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论:超声引导下神经阻滞麻醉在PFNA中能有效减轻患者术后疼痛强度,缩短苏醒时间和拔管时间,降低对免疫功能的影响,安全性良好。

Objective: To study the effect of ultrasound-guided nerve block anesthesia in the operation of proximal femoral antirotation intramedullary nail(PFNA). Method: A total of 88 patients who received PFNA treatment in Wuxi Xinwu Huawei Hospital from June 2020 to June 2021 were selected as the study subjects and they were divided into experimental group and control group by random number table, 44 cases in each group. General anesthesia was used in the control group, and nerve block anesthesia under ultrasound guidance was used in the experimental group at the same time. The anesthesia effect, postoperative pain intensity, immune factor level and safety effect were compared between the two groups. Result: The awakening time and mask removal time of the experimental group were earlier than those of the control group, and the differences were statistically significant(P<0.05). The scores of digital pain rating scale(NRS) in the experimental group at 6 h, 12 h and 24 h after operation were lower than those in the control group, and the differences were statistically significant(P<0.05).The levels of CD4^(+), CD8^(+), CD4^(+)/CD8^(+)in the experimental group were significantly higher than those in the control group, and the differences were statistically significant(P<0.05). The incidence of adverse reactions in the experimental group was lower than that in the control group,and the differences were statistically significant(P<0.05). Conclusion: The application of ultrasound-guided nerve block anesthesia in patients with PFNA can effectively reduce the intensity of postoperative pain, shorten the recovery time and extubation time,and effectively reduce the adverse impact on the immune function. The overall safety effect is good.