超声引导下髂筋膜间隙阻滞复合浅全麻在老年髋关节置换术中的应用及对患者体征、术后恢复的影响研究

Study on the Application of Ultrasound-guided Iliac Fascial Gap Block Compounded with Superficial General Anesthesia in Elderly Hip Arthroplasty and the Effects on Patients' Signs and Postoperative Recovery

目的 探讨在老年髋关节置换术中采用超声引导下髂筋膜间隙阻滞复合浅全麻对其体征和术后恢复效果的影响。方法 回顾性选取2022年9月—2023年6月莆田九十五医院100例行老年髋关节置换术患者的临床资料,根据不同的麻醉方式分为两组,对照组(n=50)采用单纯全麻,观察组(n=50)采用超声引导下髂筋膜间隙阻滞复合浅全麻,对比两组患者不同时间点的生命体征、手术时间、术后恢复时间、术前术后的疼痛程度、髋关节功能及并发症发生率。结果 观察组切皮后5 min、扩髓腔时和手术结束时的心率和平均动脉压均低于对照组,差异有统计学意义(P均<0.05);观察组手术时间、苏醒时间、拔管时间和下床活动时间均短于对照组,差异有统计学意义(P均<0.05);术后,观察组视觉疼痛模拟评分(Visual Analogue Scale,VAS)少于对照组,差异有统计学意义(P<0.05);术后5 d,观察组Harris髋关节功能评分(90.63±5.74)分高于对照组的(87.16±5.82)分,差异有统计学意义(t=3.002,P<0.05);观察组并发症发生率2.00%低于对照组16.00%,差异有统计学意义(P<0.05)。结论 在老年髋关节置换术中采用超声引导下髂筋膜间隙阻滞复合浅全麻在稳定生命体征方面有显著作用,且该麻醉方法可以有效缩短手术时间和术后恢复时间,减轻其疼痛程度,促进其髋关节功能的恢复,减少并发症的发生。

Objective To investigate the clinical effects of ultrasound-guided iliac fascia gap block combined with superficial general anesthesia on the signs and postoperative recovery effects in elderly hip arthroplasty.Methods Clinical data of 100 elderly patients undergoing hip replacement in Putian 95th Hospital from September 2022 to June 2023 were retrospectively selected and divided into two groups according to different anesthesia methods.The control group(n=50) received simple general anesthesia,and the observation group(n=50) received ultrasound-guided iliofascial space block combined with shallow general anesthesia.The vital signs,operation time,postoperative recovery time,preoperative and postoperative pain level,hip function and complication rate were compared between the two groups at different time points.Results The heart rate and mean arterial pressure in the observation group were lower than those in the control group at the time of 5 min after skin resection,pulp cavity enlargement and after operation,the differences were statistical significance(all P<0.05).The operation time,recovery time,extubation time and getting out of bed time in observation group were shorter than those in control group,and the differences were statistically significant(all P<0.05).After surgery,the Visual Analogue Scale(VAS) of the observation group was less than that of the control group,and the difference was statistically significant(P<0.05).5 days after surgery,the Harris hip function score(90.63±5.74) in the observation group was higher than that in the control group(87.16±5.82),and the difference was statistically significant(t=3.002,P<0.05).The incidence of complications in the observation group was 2.00% lower than that in the control group,the difference was statistical significant(P<0.05).Conclusion The use of ultrasound-guided iliac fascia gap block combined with superficial general anesthesia in elderly hip arthroplasty has a significant role in stabilizing vital signs,and this anesthesia method can effectively shorten the duration of the operation and the postoperative recovery time,reduce the degree of pain,promote the recovery of their hip joint function and reduce the occurrence of complications.