腹股沟韧带上行FICB应用于老年股骨颈骨折患者人工股骨头置换术中的效果

Effect of Ascending FICB of Inguinal Ligament in Artificial Femoral Head Replacement in Elderly Patients with Femoral Neck Fracture

目的:探讨腹股沟韧带上行髂筋膜间隙神经阻滞(FICB)应用于老年股骨颈骨折患者人工股骨头置换术中的效果。方法:选择2021年1月—2023年1月福建医科大学附属漳州市医院收治的100例老年股骨颈骨折患者作为研究对象,按照随机数表法将患者分为对照组(n=50)和观察组(n=50)。对照组给予腹股沟韧带下行FICB治疗,观察组给予股沟韧带上行FICB治疗。观察两组围手术期指标、术后康复指标、术后不同时间点疼痛程度及心率变化。结果:两组手术时间比较,差异无统计学意义(P>0.05);观察组术中失血量、静脉镇痛泵24 h用药量少于对照组,术后首次下床时间、出院时间短于对照组,差异有统计学意义(P<0.05)。术后6 h,两组视觉模拟评分法(VAS)评分比较,差异无统计学意义(P>0.05);术后12 h、24 h,两组VAS评分高于术后6 h,但观察组低于对照组,差异有统计学意义(P<0.05)。两组穿刺前心率比较,差异无统计学意义(P>0.05);观察组椎管内麻醉体位摆放前、切皮前、切皮后、术后即刻心率低于对照组,差异有统计学意义(P<0.05)。结论:腹股沟韧带上行FICB应用于老年股骨颈骨折患者人工股骨头置换术中可有效促进术后康复,缓解术后疼痛程度,降低心率。

Objective:To explore the effect of the ascending fascial space nerve block(FICB)of inguinal ligament in artificial femoral head replacement in elderly patients with femoral neck fracture.Method:A total of 100 elderly patients with femoral neck fracture who admitted to Zhangzhou Hospital Affiliated to Fujian Medical University from January 2021 to January 2023 were selected as the research objects,the patients were divided into the control group(n=50)and observation group(n=50)according to the random number table method.The control group was given downward FICB of inguinal ligament,and the observation group was given ascending FICB of of inguinal ligament.The perioperative indexes,postoperative rehabilitation indexes,postoperative pain degree and heart rate change were observed in two groups.Result:There was no significant difference in operation time between two groups(P>0.05);the intraoperative blood loss and 24 h dosage of intravenous analgesia pump in the observation group were less than those in the control group,and the first time to get out of bed and discharge time after operation were shorter than those in the control group,the differences were statistically significant(P<0.05).At 6 h after operation,there was no significant difference in visual analogue scale(VAS)score between two groups(P>0.05);at 12 h and 24 h after operation,the VAS scores of two groups were higher than those at 6 h after operation,but which in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).There was no significant difference in the heart rate between two groups before puncture(P>0.05);the heart rate of the observation group before placement of intraspinal anesthesia position,before skin incision,after skin incision,and immediately after operation were lower than which of the control group,and the differences were statistically significant(P<0.05).Conclusion:The ascending FICB of inguinal ligament in artificial femoral head replacement in elderly patients with femoral neck fracture can effectively promote postoperative rehabilitation,relieve postoperative pain degree and reduce heart rate.